A dose of reality about the business of health care

May 24, 2013
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Welcome to The Dose, a blog about the business of health care. As your host, J.K. Wall, I'll be writing about the most interesting new developments I see at hospitals, doctors, insurers, employers, patients, drugmakers, device companies and medical researchers around Indianapolis and around the country.

I've been covering the world of health care since early 2007, including the mammoth health reform debate, which gave us the Patient Protection & Affordable Care Act of 2010. By now, I know a little bit about the field, but mostly I just try to learn more each day, then share those tidbits with you.

On this blog I will direct you to my articles and other analysis I find interesting. But I'll discuss the financial reasons that lie behind the decisions of every organization in health care--including, if not especially, the not-for-profit ones. Everyone in health care likes to describe themselves in righteous terms, as healing the sick and comforting the afflicted out of nothing but a selfless heart. It's my job to inject a dose of reality into the situation.

Please join the conversation. Your comments, and especially your criticisms, are always welcome.

  • Congratulations
    Congratulations on your blog's debut J.K. I'm looking forward to your posts. Is there a way to read blog posts in an RSS reader or by e-mail?
    • Thanks
      Jack, You can use an RSS reader using this web address: http://www.ibj.com/blog?blogId=12. There's no e-mail for The Dose, yet, but it's something we're discussing for the future. Thanks for reading and commenting. -- J.K.
    • Recent posts
      Excellent series of articles regarding Obamacare. I have been telling folks for some time there will be some who will be very happy with the new law but in my opinion many more will not be and this is not the way it had to be. That being said, please clarify---- I have been told that self-insured plans will essentially be treated the same as fully-insured plans under Obamacare, with the possible exception of the community rating. I was so informed by several lawyers who work extensively in this area. Could you clarify? Thanks and again excellent blogs.
      • Self-insurance
        Mr. Brown, Thank you for your comments. Nearly all of the employer requirements of the Affordable Care Act apply to both fully insured and self-insured employer groups. However, there are three key exceptions: community rating, the insurance tax and the essential health benefits requirements. You can read a bit more about it in this report: http://www.rand.org/content/dam/rand/pubs/technical_reports/2011/RAND_TR971.pdf. Now, the EHBs exemption may not prove to be that significant because self-insured employers are still required to offer plans with a minimum actuarial value of 60%. But they could skimp on coverage in certain areas, if they wanted to do so. That's my understanding. I hope that helps.

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      1. With Pence running the ship good luck with a new government building on the site. He does everything on the cheap except unnecessary roads line a new beltway( like we need that). Things like state of the art office buildings and light rail will never be seen as an asset to these types. They don't get that these are the things that help a city prosper.

      2. Does the $100,000,000,000 include salaries for members of Congress?

      3. "But that doesn't change how the piece plays to most of the people who will see it." If it stands out so little during the day as you seem to suggest maybe most of the people who actually see it will be those present when it is dark enough to experience its full effects.

      4. That's the mentality of most retail marketers. In this case Leo was asked to build the brand. HHG then had a bad sales quarter and rather than stay the course, now want to go back to the schlock that Zimmerman provides (at a considerable cut in price.) And while HHG salesmen are, by far, the pushiest salesmen I have ever experienced, I believe they are NOT paid on commission. But that doesn't mean they aren't trained to be aggressive.

      5. The reason HHG's sales team hits you from the moment you walk through the door is the same reason car salesmen do the same thing: Commission. HHG's folks are paid by commission they and need to hit sales targets or get cut, while BB does not. The sales figures are aggressive, so turnover rate is high. Electronics are the largest commission earners along with non-needed warranties, service plans etc, known in the industry as 'cheese'. The wholesale base price is listed on the cryptic price tag in the string of numbers near the bar code. Know how to decipher it and you get things at cost, with little to no commission to the sales persons. Whether or not this is fair, is more of a moral question than a financial one.