Archive for January 3rd, 2011

Why the flap over end-of-life consultations?

January 3, 2011

Last week’s disclosure that MediCare will now gladly reimburse doctors for annual chats with patients re: the desirability calling it a day and heading for heaven has revived the death panel uproar.

Why?

First, to put the flap in context: ObamaCare doesn’t fundamentally restructure healthcare delivery  …  it just rearranges the flow of money and patients.

  • Folks who are already covered by insurance plans will pay higher premiums to cover the costs of folks on the margin who were previously denied coverage (pre-conditions, adult children)
  • Healthy folks (mostly young adults) who previously opted to self-insure (i.e. to not buy insurance because they are health & cocky and conclude that they don’t need health insurance), will be forced to buy insurance that they will underutilize (because they are healthy) …  to subsidize high cost, unhealthy insurance plan members (who will take out more than they put in).
  • Healthcare will be throttled to old folks –- who consume a lot of healthcare in their last years — to save MediCare $$$ that will fund healthcare for the folks who are currently uninsured.

The current uproar revolves around the latter provisions.

While end of life consultations don’t really represent death paneling, they are a significant step in that direction — they are a form of soft rationing that – in concept — allows patients to voluntarily opt out of end of life medical services. 

Some argue that’s a slippery slope.

What if doctors are incentivized by the Feds to skew the conversations towards terminal strategies? Or, what if doctors are incentivized to hush-up available life prolonging options?

Then, the soft rationing begins to harden. 

Can you imagine the Feds incentivizing doctors to promote terminal treatment options or the gov’t refusing to reimburse for near end of life procedures for certain ‘unworthy’ patients.  Hmmm.

To some people, that starts to sound like death panels.

And, that’s why there’s an uproar.

Posted in Health Care / Medical Insurance | 1 Comment »

Target Gets Fresh with Mommies

January 3, 2011

TakeAway: Target has been aggressively marketing its fresh food offerings this year in a major nationwide campaign, which includes direct mail, billboards, television, radio and vehicle wraps, among other elements.

The ads focus in part on the three daily meals that could be put together with a trip to the store, and the company hopes its efforts will resonate with mothers, who are a prime target of the campaign.

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Excerpted from NYTimes, “Shopping at Target?  Now You Can Pick Up a Dozen Eggs” By Tanzina Vega, December 16, 2010

While Target has carried snack foods like potato chips and soft drinks for years, the company has expanded to include fresh groceries like steak, chicken, eggs and apples. So far, 350 of the 1,752 Target stores nationwide have been reformatted to include the new food layout, and the company expects to add the arrangement to additional stores at the rate of about 400 a year.

While the fresh food offerings will include items similar to what a customer can find in a grocery store, “The concept is built around the notion of fill-in trips and convenience trips. There’s a real need for convenient and affordable grocery options.”

Target stocked fresh food items alongside local products like Turkey Hill ice cream, Ellio’s Pizza and Herr’s potato chips.

To market the concept, the company ran ads in local newspapers, used direct mail and placed door hangers on homes. It also used “guerrilla tactics,” like distributing 10,000 samples of produce on the streets of Philadelphia using branded bicycles and trucks with the Target bull’s-eye logo and “Get Fresh Philadelphia!” messages.

The look of the campaign incorporates Target’s bold red lettering against a white background with fruits and vegetables splashed across the layout.

Edit by AMW

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Full Article:
http://www.nytimes.com/2010/12/17/business/media/17adco.html?_r=2&ref=media

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Posted in Mktg - Consumer Behavior, Retailing | 1 Comment »

Perspective on Federal revenues (aka “taxes) …

January 3, 2011

Interesting chart from Heritage, referenced in a Forbes article …

Couple of takeaways:

As the headline says, Fed revenues have tripled since 1965 … that’s about 3% per annum … pretty much in line with GDP growth.

No big news there.

I added the line connecting 1965 and 2010 … note the 2 recent bulges above the long-term trend line … the first courtesy of the Clinton tax hikes and the dot-com bubble …  the 2nd courtesy of the Bush tax cuts and the housing bubble.

What’s common?

Fed revs jumped during the bubbles … but, rather than the Feds treating the inflows as “found money”, they treated it as a permanent change in the revenue stream and poured it into spending programs … all of which are now apparently untouchable.

Hmmm.

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Posted in Gov't Spending, Taxes | Leave a Comment »