This short slide show was sent to me by a friend.
It really resonated with me, so I thought I’d share it with you.
Merry Christmas and Happy New Year to all !
… back with you after the New Year
* * * * *
click picture or link below to launch
then click to advance slides
( best with audio on)
https://homafiles.info/wp-content/uploads/2009/12/45lesonsinlife-091118003935-phpapp02.pps
Reid thinks he was really clever with the ObamaCare provision that limits insurance companies to spending 20% or less of premiums collected on SG&A — sales, general & admin costs — including exec comp.
Ken’s Bet: It’ll cause healthcare costs and premiums to go up. Here’s why …
Assume that Acme Insurance currently collects $7.5 million in premiums — pays out $5.25 million to healthcare providers (docs, hospitals, pharmacies, etc.) — and spends $2.25 million (30%) on SG&A.
Reid thinks his rule will cut premiums by about $1 million — thanks to a roughly $1 million cut in SG&A.
WRONG !
Here’s a more likely outcome:
Acme holds its SG&A constant and simply starts selling more liberal plans (maybe all the way up to the Cadillac limit) to force fit within the 20% limit — for example, Acme charge $11.25 million in premiums to cover $9 million in payouts ( lower co-pays & deductibles, more botox) and allow $2.25 of SG&A (20% of $11.25).
PRESTO!
Rather than healthcare costs coming down and premiums getting reduced, premiums and healthcare expenditures go up by 50% … SG&A stays the same … insurance execs still drive fancy cars.
Ken’s Take: The DC boneheads have zero conception of how businesses run …
I posted this a couple of weeks ago — an editorial by the head of Johns Hopkins.
His view: A vast expansion of the Medicaid program — without adequate risk-adjusted reimbursement rates — will impose unsustainable costs on healthcare providers.
With the Senate bill on its way to passage, it’s worth a re-read — a prediction of what’s to come from somebody who knows.
* * * * *
Excerpted from WSJ: Health Reform Could Harm Medicaid Patients, Dec. 4, 2009
Both the House and Senate health-care reform bills call for a large increase in Medicaid—about 18 million more people will begin enrolling in Medicaid under the House bill starting in 2013.
A flood of new patients will be seeking health services, many of whom have never seen a doctor on more than a sporadic basis. Some will also have multiple and costly chronic conditions. And almost all of them will come from poor or disadvantaged backgrounds.
Johns Hopkins’ Priority Partners handles Medicaid patients under a capitated system — that is, it receives a set payment per individual per month from the state.
Over time, we’ve developed the ability to manage the care of these individuals in a way that is both cost effective and that provides them with quality care. We’ve done it by tapping into our extensive delivery system, which includes four hospitals, a nursing home, the largest community-based primary care group in Maryland, and much more.
We’ve hit above-national benchmarks on all clinical quality measures, reduced monthly costs for patients with substance abuse and highly complex medical needs, and 70% of our patients tell us they’re satisfied with our care.
The key fact is that for years the state did not cover all the costs our Medicaid program incurred. As a result of new patients whose costs were not completely covered by the state, Priority Partners lost $57.2 million from 1997 to 2005.
We stanched the losses by ensuring that the payment from the state was appropriately risk adjusted to match the health conditions of our members, and by investing heavily in primary-care and care-management and disease-management programs.
Yet this past year the losses began again, because the state expanded the program’s eligibility to 116% of the federal poverty level up from 40%.
So we are struggling with a large group of new patients—about 30,000 people. Today, like in the late 1990s, a health-care surge is overwhelming our managed-care system. The capitated rate for the new beneficiaries is not yet risk-adjusted. Priority Partners has lost a devastating $15 million in just nine months.
Congress can help, or at least learn from our experience to use the reform legislation to bend the cost curve if it encourages other states to institute and appropriately fund capitated systems that allow capable providers to adjust payments based on risk. The key is that federal support to states for Medicaid must appropriately adjust rates to match the risk of providing health care to the group of people who are covered by Medicaid.
The Senate bill would increase eligibility for Medicaid to those who make 133% or less of the federal poverty level. The Kaiser Family Foundation reports there are 308,000 people who meet that threshold in Maryland.
Even if only half of those individuals seek Medicaid coverage, such a large expansion would likely have an excruciating impact on the state’s budget.
Without an understanding by policy makers of what a large Medicaid expansion actually means, and without delivery-system reform and adequate risk-adjusted reimbursement the current health-care legislation will have catastrophic effects on those of us who provide society’s health-care safety-net.
In time, those effects will be felt by all of us.
Full article:
http://online.wsj.com/article/SB10001424052748703939404574567981549184844.html?mod=djemEditorialPage
Takeaway: The latest breakthrough in online innovation has come from a rather unsuspecting source: Hollywood playboy Ashton Kutcher. He’s taken his act to the web, and has lured an entourage of prominent consumer brands along with him.
Kutcher’s new format merges traditional entertainment, advertising, and social networking into a seamless product. The programming has attracted droves of viewers, and companies like Pepsi and Nestlé believe that this format will enable them to drive deeper levels of customer engagement.
In the crowded world of webertainment one other characteristic sets this pied piper apart from the other online media moguls – he’s intensely profit-focused.
* * * * *
Excerpt from Fast Company, “Mr. Social: Ashton Kutcher Plans to Be the Next New-Media Mogul,” by Ellen McGirt, Issue 141, December, 2009.
Ashton Kutcher, best known for his eight seasons as Michael Kelso on That ’70s Show, and on his hit MTV show Punk’d, is using his media company, Katalyst, to pioneer a new kind of business bridging Hollywood, technology, and Madison Avenue.
Kutcher and his partner, Jason Goldberg, spent the better part of two years courting the wizards of Silicon Valley, converting them from teachers and skeptics to friends and allies. For all their pranks, Katalyst can claim one thing most other social-media businesses can’t – profitability.
It’s not just talk. Some 3.9 million people follow Kutcher on Twitter, and he has nearly 3.3 million Facebook fans. Those numbers have helped attract corporate clients including Nestlé, Pepsi, and Kellogg.
Katalyst series, HQ, illuminates what Kutcher’s production company wants to become – not just a home for his television and movie projects but also a go-to source for brands looking to deploy what’s called “influencer marketing,” a hybrid of entertainment content, advertising, and online conversation that finds its audience via video, animation, Twitter, blogs, texts, and mobile. “Entertainment is a dying industry,” says Kutcher. “We’re a balanced social-media studio, with revenue streams from multiple sources” – film, TV, and now digital. “For the brand stuff, we’re not replacing ad agencies but working with everyone to provide content and the monetization strategies to succeed on the Web.”
Kutcher is not exactly the image of a business visionary, but he intends to become the first next-generation media mogul, using his own brand as a springboard.
Still, even if Kutcher turns out to be more style than substance and Katalyst doesn’t become the next big thing, Kutcher’s experiment points toward a new model for the evolving media business.
What the Katalyst team is planning, he says, is simple – make entertaining stuff, give it to people where they already are, let them have some fun with it, and mix in brand messaging. And because of the viral nature of the Web, each new consumer is cheaper to win than the last one. “We know how to gain and activate and retain an audience,” Kutcher says. “We create social networks for brands.”
This is the way things are going, says Netscape founder Marc Andreessen. “Katalyst is way out on the leading edge in terms of thinking this stuff through,” he says. Katalyst steps into the gap left by ad agencies that gave up on the Web after the dotcom bust. “Banner ads aren’t going to cut it,” he says. “And media companies have not been creative or aggressive about making products designed for engagement marketing. Now that’s changing, giving brand advertisers a new way and reason to buy.”
It is Katalyst’s work with Pepsi on something called DEWmocracy that may best illustrate the model Kutcher & Co. is after. The first iteration of DEWmocracy was a reasonably successful promotion – a destination site with an animated film made by actor Forest Whitaker, where fans could pick the next Mountain Dew flavor. For the second iteration, chief marketing officer for Pepsi says, “Katalyst had new ideas about where we could find value in the social-media space and how to mobilize large groups of people.” The campaign, which runs through early 2010, lets people pick not only the flavor, name, color, and label of new sodas but eventually the in-store merchandising and the ad agency, in an online bake-off. Fans can also submit their own ads. “My theory is, you have to engage the constituency and let them be the voice of the brand,” says Kutcher. “I help connect people to the Mountain Dew brand so they can be creative with it.”
Mountain Dew’s Facebook fan page grew fivefold at the launch, but the big win is inside Pepsi. “A lot of senior managers at consumer brands feel like their role is to control the communications around a brand,” a Pepsi executive explains. They are uncomfortable with the transparency of social media because “people will say negative things about you.” What makes him happiest about DEWmocracy, he says, is “the competency we’re building throughout the organization in using these new tools. It’s a symbol of what’s possible within brand marketing at Pepsi.”
Kutcher and Goldberg acknowledge that Katalyst today is still primarily a film-production studio. And not all on that end is going swimmingly. Its most recent Kutcher vehicle, Spread, earned a pathetic $250,000 in the United States. For 2010, Kutcher has two major features coming out, and Katalyst is producing an experimental film that could easily flop. “We’re taking a big risk, but we’re all about learning,” says Goldberg.
Edit by BHC
* * * * *
Full Article: http://www.fastcompany.com/magazine/141/want-a-piece-of-this.html?#
* * * * *
One View: “Everyone should work out their own environmental impact. I should be allowed to say that I walk instead of using my car and that I don’t eat meat, so why shouldn’t I be allowed to have a little cat to alleviate my loneliness?”
And, another …
* * * * *
Excerpted from AFP: Polluting pets: the devastating impact of man’s best friend, Dec 20, 2009
According to the book “Time to Eat the Dog: The Real Guide to Sustainable Living”, man’s best friend could be one of the environment’s worst enemies, according to a new study which says the carbon pawprint of a pet dog is more than double that of a gas-guzzling sports utility vehicle.
A medium-sized dog eats around 164 kilos (360 pounds) of meat and 95 kilos of cereal a year.
Combine the land required to generate its food and a “medium” sized dog has an annual footprint of 0.84 hectares (2.07 acres) — around twice the 0.41 hectares required by a 4×4 driving 10,000 kilometres (6,200 miles) a year, including energy to build the car.
“Owning a dog really is quite an extravagance, mainly because of the carbon footprint of meat.”
Other animals aren’t much better for the environment.
Cats have an eco-footprint of about 0.15 hectares, slightly less than driving a Volkswagen Golf for a year.
“If pussy is scoffing ‘Fancy Feast’ — or some other food made from choice cuts of meat — then the relative impact is likely to be high.”
“If, on the other hand, the cat is fed on fish heads and other leftovers from the fishmonger, the impact will be lower.”
Two hamsters equate to a plasma television and even the humble goldfish burns energy equivalent to two mobile telephones.
And pets’ environmental impact is not limited to their carbon footprint, as cats and dogs devastate wildlife, spread disease and pollute waterways, the Vales say.
With a total 7.7 million cats in Britain, more than 188 million wild animals are hunted, killed and eaten by feline predators per year, or an average 25 birds, mammals and frogs per cat.
Likewise, dogs decrease biodiversity in areas they are walked, while their feces cause high bacterial levels in rivers and streams, making the water unsafe to drink, starving waterways of oxygen and killing aquatic life.
And cat poop can be even more toxic than doggy doo — owners who flush their litter down the toilet ultimately infect sea otters and other animals with toxoplasma gondii, which causes a killer brain disease.
As with buying a car, humans are also encouraged to take the environmental impact of their future possession/companion into account.
But the best way of compensating for that paw or clawprint is to make sure your animal is dual purpose, the Vales urge. Get a hen, which offsets its impact by laying edible eggs, or a rabbit, prepared to make the ultimate environmental sacrifice by ending up on the dinner table.
“Rabbits are good, provided you eat them.”
Full article:
http://news.yahoo.com/s/afp/20091220/lf_afp/lifestyleclimatewarminganimalsfood
* * * * *
Thanks to Coop for stringing the lead
The Homa Files 