Obamacare Premium analysis

ObamaCare Premium Analysis

1         Executive Summary

Data analysis was performed on the recently published 2016 premium data for the healthcare policies offered over the federal exchanges under the Affordable Healthcare Act (colloquially referred to as ObamaCare).  Obamacare is a politically charged subject, has been litigated a number of times all the way to the supreme court, number of bills passed by congress trying to defund it and a lot of articles have been written in the past on its eventual failure from a death spiral event (wherein only the sickest of the sick enroll in the plan, leading to an exponential increase in premium that will make it unaffordable).  Obamacare has survived a number of challenges and has currently enrolled 13 million members (premium paying) across the US, either through state or federal exchanges.  The current data analysis tries to shine some light on the premium data and provide the general public a narrative of what the published premium data tells us.   All of the data analyses in this document were done using Tableau public and there was some amount of data shaping that was required before useful analyses could be done.  Tableau public makes data shaping and transformation easy.  The data analyses will be expanded over time as time permits and based on comments from readers. 

Good vs Bad Strategies - Why so much Bad Strategy?

1         Good vs Bad Strategies

Strategies are developed to achieve Goals.  It is not known at the outset whether the goal is an achievable goal or just a pie in the sky wishful thinking.  Knowledge about the hallmarks of good and bad strategies would allow us to steer clear of bad strategies from the outset.  Strategy development is very context dependent but the general principles of good strategies still apply.  The corporate world in general is littered with companies that have pursued both good and bad strategies to further their businesses, and have led either to their success or demise.  The discussion on good strategies vs bad strategies will give some grounding for the formulation of workable good strategies.  The document is organized into three broad sections – Hallmarks of Bad Strategies, Underpinnings of Good Strategies, Strategic tools in use to analyse businesses.  The discussion on the Good vs Bad strategies and the Strategic tools have generously borrowed content from two books: “Good Strategy, Bad Strategy, The Difference and Why it matters” by Richard Rumelt and “Lords of Strategy” by Walter Kiechel.  I am not delivering any new content but just summarizing content from these books and summaries are sometimes useful as a quick guide.  I would recommend readers to go through these two books if they find the summaries interesting. 

Medicare Cost Data Analysis

Medicare Cost Data Analysis

1         Executive Summary

Data analysis was performed on the recently published Medicare Provider Utilization and Payment Data for (a) Physicians and Other suppliers and (b) Inpatient.  A lot of news articles have been written in the past about the huge variability in billed charges among regional hospitals and how some physicians are getting reimbursed millions of dollars by Medicare.  The current data analysis tries to shine a broader light on the data and provide the general public a narrative of what the published data tells us.   The data analyses will be expanded over time as time permits and based on comments from readers.   

• The data analysis found that at least 60 doctors have had Medicare reimbursements above $5 million in calendar year 2012.  The top doctor had $21 mil in Medicare reimbursements.  All of these reimbursements may have been legitimate but then it begs the question of how a single doctor can be so productive and efficient.  Are these the super-doctors that the medical field should emulate?  Are the taxpayers and retirees getting full value for their money at these levels of reimbursements? 
• Ophthalmology is the second highest doctor category in terms of Medicare reimbursements, after Internal Medicine.  It is even higher than Cardiology.  What are the common ophthalmological procedures done on retirees other than cataract operations?   If ophthalmological procedures are that expensive, then we are not hearing enough ads in the general society about preventive measures on eye health like the way we hear about healthy heart. 

Lords of Strategy book

I have to comment about this book as this has been one of the best books I have read in the past 4 years.  Here is the link to the amazon website for this book http://www.amazon.com/Lords-Strategy-Intellectual-History-Corporate/dp/1591397820/ref=sr_1_1?ie=UTF8&qid=1326330950&sr=8-1

very engrossing, goes thru the history of all the strategy tools developed since the 60s.  gives a good perspective on how all these tools got developed, stories of consulting war along the way.  All those frameworks taught in the MBA school suddenly become much more contextual - the 7Ss, growth share matrix, five forces.  It is an unbiased treatment I would say, trashes a lot of consulting cos and academics along the way.  All these consultants pushed all these frameworks as magic bullets to grow cos and the results are spotty.   The frameworks provide a way to understand what is happening in the competitive environment but that doesn't automatically provide a way to act to your advantage.  It all depends how the info from the framework can be used to a company's advantage and execution is always a problem.  I wish I had this book when I went to the MBA school, would have given me the context to understand all the strategy tools that were taught in the courses.  The book was only published in 2010, so impossible for me to have had this book then. 

Are the Rich obstructing Job creation?

There was an article a week back by Henry Blodget on a rich American destroying the Fiction that Rich people create the Jobs http://finance.yahoo.com/blogs/daily-ticker/finally-rich-american-destroys-fiction-rich-people-create-152949393.html  The Rich american he quotes is Nick Hanauer.  "Suggesting that "rich entrepreneurs and investors" create the jobs, therefore, Hanauer observes, is like suggesting that squirrels create evolution."  The whole article is based on a wrong premise.  Job creation has nothing to do with the rich, middle class or the poor.  Job creation happens when there is more exchange of goods and services between people (read economic growth) and when this higher activity of exchange needs more people to support the exchange.  The whole eco system surrounding an economy matters - it is not just entrepreneurs or the customers or the govt that is solely responsible for job creation.  Everything must work together to keep the economic machine (of goods and services exchange) running smoothly.

Entrepreneurs play their part by thinking up new products or services that people may be interested in exchanging and those new products or services are necessary for the economy to grow.  The people involved in the exchange must have productive skills to make the exchange happen.  We all earn a certain amount of money based on the skills we possess and that money is used to exchange for products or services with other people.  If I need to afford to buy an iPhone, I must have provided sufficient skilled work in the economy to be able to afford the iPhone.  Ultimately the economic growth and job creating power of a nation comes down to the productivity of the people in the economy.  Productivity is measured in the amount of resources needed to create a certain product or service.  The Productivity increases as we learn to use lower amount of resources to create the same product or service - this raises the standard of living of a nation.  The reason I can't sell an iPhone to an average Bangladeshi is because that average person in Bangladesh is not productive enough to sell a service or product in exchange for an iPhone.