Category Archives: Healthcare

Your Medicare Part D prescription drug plan bets

Pill bottle

In recent posts, I have discussed viewing the selection of Medicare Part B Medigap and Part C Advantage plans as a set of probabilistic “bets” that you are making with your money against your health. This post extends that idea to Medicare Part D prescription coverage plans that were first instituted in the early 2000s during the George W. Bush… Read more »

The human costs of innumeracy

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Samoa

“I don’t do math!” How often have you heard this expression, sometimes more as a brag than an excuse for some consequential mistake? As of December 19, 2019, seventy-seven people, many of them small children, had died in the small South Pacific island nation of Samoa. The cause of the epidemic was a confluence of several factors, but a significant… Read more »

The bad Medicare Advantage bet

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Life Expectancy

In a prior post on Medicare Part B “Medigap” plans I hinted at my dislike for Medicare Advantage. I have found that lots of people really like their Medicare Advantage plans. Almost all, in my experience, are healthy seniors or have retired with a high-end employer-sponsored Advantage plan. On the other hand, there are many horror stories of seniors who… Read more »

Seven bets on your Medicare supplement

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Medigap

An old cynical joke says that when you buy life insurance, you are betting that you are going to die, while the life insurance company is betting that you are going to live. Having just survived the annual mail onslaught from prospective Medicare supplement providers, I found it helpful to view the different plan options as bets on several different… Read more »

The first layers of hidden healthcare costs

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In a recent debate, Joe Biden said that 160 million people like their private insurance. PolitiFact rated this statement as “half true.” This is the number of people who are insured through their employers, and most of these people generally rate this insurance as satisfactory. They shouldn’t. That benefit is much more shaky than most of them think. Even more… Read more »

The bottom-up capitalism of Elizabeth Warren

I have lived and worked in Europe in past years, and we still visit regularly. Contrary to the views of Americans who never have traveled there, “classic capitalism” is alive and well in small communities across supposedly “socialist” northern Europe, and they are often far healthier than many U.S. communities of similar size. Small-business entrepreneurship is commonly evident and the… Read more »

The “giant cash suck” of healthcare – part 2

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In a prior post I introduced my view that we are not paying enough attention in the healthcare discussion to the top-line “giant cash suck” that causes U.S. healthcare costs to be over twice the per-capita level of many countries that achieve true universal coverage while delivering equal or better outcomes. In this second part, I will explore where much… Read more »

The “giant cash suck” of healthcare – part 1

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Michigan

What do the great cathedrals of Europe, the Las Vegas “Strip” and an impressive new hospital in economically-challenged northern Michigan have in common? They all answer the question, “Who controls the big cashflow here?” I have been struck in awe visiting many Old Europe cathedrals, but I also have been troubled by the “real history” of the stark contrast between… Read more »

Acceptable carnage: the gun deaths that are easily preventable

Per-day gun violence

Whenever I review the updated numbers from the excellent Gun Violence Archive project, I am struck by the unrelenting “randomness with predictability,” in effect the cruelest of lotteries, that are the rates of gun violence casualties in the United States. You just don’t find any numbers like these anywhere else in the developed world. And note how little these per-day… Read more »

Stop calling them “healthcare insurance companies”

If we are really going to make improvements to healthcare system in the United States, let me suggest that we start by stopping something. We are obscuring a huge reality when we refer to Aetna, Cigna, United Healthcare and their ilk as “healthcare insurance companies,” and we need to change that terminology in order to really understand what is going… Read more »