Hospital pricing

The Economix blog at the New York Times has a guest article that discusses hospital procedure pricing and revenue sources. From our experiences in a small dental practice, much of the same discussion on revenue sources applies as well. However, the range is more tightly bound than the orders of magnitude difference described in the practice.

From the article, it seems:

  • Medicare (Federal) tries to pay at hospital cost
  • Medicaid (State/Federal) on average pays far under hospital cost
  • Private insurance generates the bulk of profit
  • Uninsured gets screwed
  • The range of prices paid by a private insurance vary widely, by orders of magnitude, and there are seemingly few consistent rules that dictate what prices will be
  • Pricing is enormously complex and (except in CA) nearly completely opaque

Better Posture

Poor posture sucks.

The problem
It starts early in life and is enormously difficult to correct once you are set. It will lead to back pains, poor breathing, and a host of other issues that won’t appear for another 20 years.

I’ve have fairly miserable posture for most of my life. I would slump while sitting, slouch while standing, and probably even curl up while lying down. When people would ask how tall I am and I tell them 6’3″, invariably the response would be similar to “Really? You don’t seem that tall.”

The resolution
I vowed (“resolved”, even?) to get past this right after Thanksgiving of last year. Like a drug addict who’s hit rock bottom, my bottom was seeing pictures from my brother’s wedding. Despite being taller than both of them, I looked shorter than them in almost every picture I can remember, and was fed up.

No more poor posture.

The tools
I dug out a book I had purchased a few years back, Posture, Get it Straight! by Janice Novak. While the book was written for someone quite a few years older and quite a few pounds heavier than myself (the subtitle is “Look Ten Years Younger, Ten Pounds Thinner and Feel Better Than Ever”, after all), and had illustrations of 50-year old woman in leotards smattered throughout the book, the principles laid out throughout the book, especially in the first two chapters, were solid.

The actions
For the past 8 weeks now, I have started the following.

  • Every time I catch myself slouching, I consciously sit upright with the “perfect posture” principle in the book.
  • Whenever I head to the gym, I focus more intensely on posture than every before: shoulders low and back, chest out, head and neck back.
  • Occasionally I will turn on the Yoga DVD that we have and run through that, as the stretching invariably helps limber up my back.
  • I’ve incorporate 2-3 core workouts into my weekly regimen. Good posture requires a strong core, both front and back. (I will detail this in a future blog post)

The results The first two weeks were tough. I caught myself slouching 10-20 times per day. When I would correct myself, my back would make snapping and popping noises. I would go to bed with an aching back at the end of the day.

But it is getting better. At least I think so. My back doesn’t pop or snap anymore. The corrections I have to take are fewer. I’m not out of the woods yet, but I definitely see improvement. And I definitely feel taller. Whereas my wife used to seem ~9-10 inches shorter than me, she is now the appropriate 12 inches shorter than me. I haven’t had any comments about how tall I don’t look in these past 8 weeks. Yes, things are looking up.

I will update this post as time goes on.

Employer charging unhealthy employees

I love this idea.

In late June, the Indianapolis-based hospital system announced that starting in 2009, it will fine employees $10 per paycheck if their body mass index (BMI, a ratio of height to weight that measures body fat) is over 30. If their cholesterol, blood pressure, and glucose levels are too high, they’ll be charged $5 for each standard they don’t meet. Ditto if they smoke: Starting next year, they’ll be charged another $5 in each check.

In short, the healthy will not subsidize the unhealthy as much.

Question 1: Is this move legal? The article hints that this is within the guidelines of HIPAA. However, is this/could this be a form of discrimination? There is more discussion of this at the end of the article.

Question 2: Will these penalties even matter? The average consumer carries over $8000 of credit card debt, probably at a very high interest rate. There are many many options to consolidate that debt to lower interest options and save thousands in interest per year. Would a consumer that does not take charge of their credit card debt, notice and take charge of deductions off of their paychecks?

Despite the outstanding questions, I applaud Clarian Health for taking the lead in fighting rising costs.

Ten Politically Incorrect Truths About Human Nature

I found this article in Psychology Today to be a really interesting set of conclusions from specific behavioral studies. The ten truths listed are:

  1. Men like blond bombshells (and women want to look like them)
  2. Humans are naturally polygamous
  3. Most women benefit from polygyny, while most men benefit from monogamy
  4. Most suicide bombers are Muslim
  5. Having sons reduces the likelihood of divorce
  6. Beautiful people have more daughters
  7. What Bill Gates and Paul McCartney have in common with criminals
  8. The midlife crisis is a myth – sort of
  9. It’s natural for politicians to risk everything for an affair (but only if they’re male)
  10. Men sexually harass women because they are not sexist

If you are pressed for time, read #1, #3 and #4 (they are related), and #8.
If you are really pressed for time, just read #1.

Why poor kids can’t find a dentist

For those of you interested in Medicaid coverage for dental work (you know who you are), Slate has a great article with some interesting facts:

Two-thirds of Medicaid children do not visit a dentist in a given year


One Maryland dentist reported that his staff called 748 dentists listed as Medicaid providers and found that only 23 percent would take new Medicaid patients


Maryland’s Medicaid payments for common dental procedures ranged from 37 percent to 73 percent of the market rate

(While you are at it, take a look at how the dental profession turned itself around in the past thirty years, from being nearly “extinct” to quite lucrative today)

The wonder drug for cancer is Vitamin D

Recent research is showing that Vitamin D may help drastically reduce cancer among women (and men?).

A four-year clinical trial involving 1,200 women found those taking the vitamin had about a 60-per-cent reduction in cancer incidence, compared with those who didn’t take it, a drop so large — twice the impact on cancer attributed to smoking — it almost looks like a typographical error.

And more.

The sun advice [of avoiding the sun or using heavy sunscreen] has been misguided information “of just breathtaking proportions,” said John Cannell, head of the Vitamin D Council, a non-profit, California-based organization.

“Fifteen hundred Americans die every year from [skin cancers]. Fifteen hundred Americans die every day from the serious cancers.”