Saturday, August 30, 2014

One emerging and successful healthcare model post 'Obamacare'

It's thriving specifically because of Obamacare - unintentionally. This may be the good news of the failing Affordable Care Act (aka 'Obamacare') that it may pave the way for models that are sustainable (Xeniagazette):

The Surgery Center of Oklahoma (SCO) has been open for 17 years, but 5 years ago decided to publish online the fees charged for various operations. Drs. Keith Smith and Steven Lantier, both anesthesiologists, felt the need to provide quality healthcare at reasonable prices. They contact local specialists and negotiate the fees charged. They include a reasonable fee for their services and add in a fair profit."

There are no hidden fees or charges.

They do not accept government funding for anything; your medical history and information are therefore not available online to the federal government – or anyone else. Most doctors agreed to computerize patient medical records and make them available online to the federal government, in return for reimbursements of the approximately $100,000 it cost them to do so.

Best of all, SCO’s maintains a zero or near-zero infection rate. Dr. Smith, CEO and managing partner of SCO believes their unbelievable low infection rate is due to their near-zero turnover rate in personnel. He commented, “Many of the people – in fact all of the people that worked for me 17 years ago – are either [still] working here, or they’re completely retired…. They just feel like it’s the best job they’ve ever had. People that are working in the same environment every day know the routine.”

Friday, August 29, 2014

Not sure what your purpose is in life? Pivot

It's not just for startups. Useful advice from Barking Up the Wrong Tree.

Delaying self driving cars: How regulations kill

Human error causes the large majority of accidents. While this isn't to say that computers can't be worse than humans (the buggy nature of most software being emblematic of this), this isn't to say technology can't also be a lot better and a lot more robust. So why won't regulators let car makers at least try?

Federal regulators are also putting the brakes on self-driving cars, which are closely related to the Uber innovation—enabling riders to order a car service using their smartphone app. If fast-moving technology hadn't collided with slow-moving regulators, this might have been the last summer you'd have to drive your own car.

Self-driving technology is reaching the limits of what U.S. regulators will allow. The 2014 Mercedes Benz S-Class sedan uses digital technology to be the first car most of the way to being self-driving. The S-Class combines active cruise control, automatic braking and lane-keeping technologies to offer what an industry analyst calls "70% autonomous driving." The car steers, accelerates and brakes on its own in congested traffic up to 40 miles an hour. On the highway, it uses numerous cameras and radars to remain centered in its lane at a safe distance from the car ahead, up to 120 miles an hour.

But U.S. regulators won't let car manufacturers go much beyond what Mercedes now offers. That means car makers can't roll out technologies they already have, and auto makers in Europe, which has fewer regulations limiting technology, have surpassed their U.S. competitors.

Wednesday, August 27, 2014

Why Britain is poorer than any US state, other than Mississippi

A story that's somewhat disruptive to a few narratives out there (TheSpectator):

It’s not surprising that America’s best-paid 10 per cent are wealthier than top 10 per cent. That fits our general idea of America: a country where the richest do best while the poorest are left to hang. The figures just don’t support this. As the below chart shows, middle-earning Americans are better-off than Brits. Even lower-income Americans, those at the bottom 20 per cent, are better-off than their British counterparts. The only group actually worse-off are the bottom 5 per cent.
Update: Maybe the Brits are poorer than even Mississippi (Forbes)

Monday, August 18, 2014

Wired's profile of Stewart Butterfield, Founder of Slack

An interesting profile of Stewart Butterfield and how he accidentally developed Flickr and now Slack which were both offspring of failed gaming projects (Wired).

Monday, August 11, 2014

Emerging consumer/market based healthcare in the US?

For the record, I think the Affordable Care Act (ACA), aka 'Obamacare' is a disaster and things will get worse before before it gets better but there are still a number of interesting experiments emerging.

While VentureBeat credits the ACA for "li[ghting] a fire under the movement to rethink they way we deliver and pay for healthcare," the examples they cite seem to show that this is despite - not because of the Act.

Cato recently highlighted the Direct Primary Care model:

“Direct primary care” is a rapidly growing alternative to the traditional “fee-for-service” model of paying for medical care. Instead of the patient or his insurance plan paying the doctor separately for each visit or service, the patient pays the physician a set monthly fee. In exchange, the physician is available to consult with and treat the patient as necessary.

For patients, the benefits of direct primary care are greater access to their doctors and more convenient and personalized care. Under direct primary care, patients can generally expect “all primary care services covered, including care management and care coordination…seven-day-a-week, around the clock access to doctors, same-day appointments, office visits of at least 30 minutes, basic tests at no additional charge, and phone and email access to the physician.” Some practices may offer additional services under the arrangement, such as EKGs or medications at wholesale cost.
In fact, studies are showing that a number of doctors abandoning the onerous demands of filing to get insurance claims in favor of cash (Forbes). Interestingly, the very first company that VentureBeat cites - Evolent Health, supports doctors who move towards a direct pay/subscription model. Healthgrades, another company cited, rates and ranks hospitals - further empowering consumers. The others - Doximity, a Linked-In for Doctors, MindForce, a CRM for health and wellness firms, and Best Doctors, a service providing expert opinions for the employees of compaanies, all operate outside the ACA. If the business models of Evolent and Healthgrades thrive, this could be the positive legacy of the Affordable Care Act.

How tax inversions have helped the US economy

A contrarian opinion from Diana Furchtgott-Roth, considering some prominent liberals have called for corporations to take a loyalty oath (TheDailyBeast) in light of recent tax inversions:

U.S.-based multinationals face a federal corporate tax rate of 35% on worldwide income, not just income generated in the United States. State taxes are extra. America is one of only seven Organisation for Economic Cooperation and Development countries that taxes companies on worldwide income, and the others have significantly lower corporate tax rates.

The United States, in fact, charges the highest tax rate in the developed world. The average of OECD countries is 24%. Some countries, such as Ireland, have corporate tax rates that are closer to half that.

If a foreign-based multinational had headquarters in Ireland, and wanted to bring back $100 million to invest in its plant in Detroit, then all the $100 million would be invested. None would go to the Treasury. Residents of Detroit would be better off, and the shareholders of the company would be better off. America would grow because companies generally spend money more effectively than does the government.

Since inverting to Panama in 1982, McDermott International MDR +2.22% has created American jobs by constructing pipelines and oil platforms in the Gulf of Mexico and across the country. Panama’s lower corporate income tax rate, 25%, leaves McDermott with more funds to hire the workers to complete those projects.

Saturday, August 09, 2014

Was Argentina bullied? Why does it matter?

So first off, anyone who reads/watches/listens to the CBC for actual business analysis deserves the returns they get. I'm not sure what is so difficult to understand: when you borrow money, the people you borrow the money from expect to be paid back in full. It doesn't seem like an unreasonable expectation that you should repay those who you owed money to first (so long as they are of the same class of debt holders) - and that is more or less what a New York court decided in the case of Argentina.

Argentina used to be incredibly wealthy. So what happened? Governments spent money it didn't have to effectively bribe their own electorate. This was their own doing (Cato). Argentina is a sovereign nation with a democratically elected government. No matter how much the CBC wants to paint them as an underdog (presumably as a historical defense of their own largesse off the backs of Canadians?), this was their own doing. Other countries should take note.

"Austerity" in the European Union

Nope, these governments couldn't possibly make any further cuts... (Cato):

Thursday, August 07, 2014

What if public transit didn't need to be... well, public?

Technology may drive public transit out of business. Uber has launched a service similar to Hitch (TechCrunch) that aims to help commuters carpool/pool cab money when they're going to similar places.

It doesn't seem like a far leap to imagine a day that you could have small mini buses or even driverless cars/buses that have the capacity to pick up more people while competing against each other (and maybe what governments should do is just create pick up points?). Market driven technology tends to save time and/or money - and in this case, it promises to do both.

Given how expensive and slow moving most public transit systems are - not to mention probably bad for the environment (Freakonomics), that may be a good thing.

Wednesday, August 06, 2014

More companies are still closing than opening in the US

Troubling (WSJ):

Especially because it's not small businesses that are the biggest creators of jobs in the US - it's new businesses (Kauffman).

A reminder that being pro-business isn't the same as being pro-markets

At least in this case, the good guys won - Justin Amash wins against opponent heavily funded by crony capitalists at the US Chamber of Commerce (DailyCaller). From Adam Smith's Wealth of Nations:

People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices. It is impossible indeed to prevent such meetings, by any law which either could be executed, or would be consistent with liberty and justice.

But though the law cannot hinder people of the same trade from sometimes assembling together, it ought to do nothing to facilitate such assemblies; much less to render them necessary. A regulation which obliges all those of the same trade in a particular town to enter their names and places of abode in a public register, facilitates such assemblies. . . . A regulation which enables those of the same trade to tax themselves in order to provide for their poor, their sick, their widows, and orphans, by giving them a common interest to manage, renders such assemblies necessary. An incorporation not only renders them necessary, but makes the act of the majority binding upon the whole.