Health Care and Fixed Costs

There are many health care plans being proposed to “fix” the growth in medical costs in the United States. Each of these plans has different elements but I haven’t really seen the particular linked issue addressed that I am going to speak of in this blog post.

I make a point of reviewing my medical bills. When you have surgery, for example, you receive an itemized bill. In that bill you can see services from each provider and also the cost for the room, medicine, etc… Frequently the costs seem far out of line from reality (outside the walls of medicine); a room could cost hundreds or thousands of dollars a night; an aspirin or readily available over-the-counter medicine could cost many dollars per pill.

The real issue is that the medical industry is primarily a “fixed cost” business, with very low “marginal costs”. For example, if you look at the Northwestern Hospital facility downtown, a vast series of interconnected buildings, and asked yourself this question:

How would costs vary on a given day if the facility was full of patients vs. having NO patients?

The answer is that the costs for that day would be virtually identical whether or not the hospital had patients. You still need to pay for the facility, the doctors, the electricity, and all the support workers and nurses. Virtually the only “variable” costs that would be avoided are the cost of medicines and food, but the medicines are inventoried and they need to hold stocks in advance and the food must be purchased based on planned demand and the spare food would just be thrown away (the costs would be pretty much the same).

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“And then they ate their pets.”

Belmont Club posts on Zimbabwe.

And so the toll that mounted to a hundred million victims in the twentieth century continues to climb in the twenty-first. And, in America, mid-west farmers are described as voting against their interests when they choose candidates who value limited government. The independence that land gives us, the productivity that comes when we till our own fields are lessons we forget over and over, but then are taught again by the harshest of experiences.

Securities Analysis and the Housing Bubble

In the general field of securities analysis (predicting stock prices) there are two basic schools of thought, fundamental analysis and technical analysis. Fundamental analysis can be summarized as saying that stocks are worth a price based on their financial statements and that investors can profit by deeply understanding the details of said information. Benjamin Graham with his book “Securities Analysis” is an example of a fundamental approach to stock valuation.

On the other hand, a different school of thought belongs to the technical analysis camp, which states that stock prices have patterns and can be bought or sold for profit based on these patterns. Technical analysts frequently chart stocks and are responsible for the myriad types of charts available at any financial web site (such as Yahoo!) including “Bollinger Bands” and the like.

Without going into the relative validity of both theories (an endless topic in and of itself) I will glibly summarize the two models as “buy it because your detailed financial analysis says it will go up in value” vs. “buy it because it has been going up and other items similar to it are going up in price”.

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Michael Lewis on Disaster-Risk Trading

This is an interesting and entertaining article, a bit long but worth reading. I’m not sure that Lewis completely understands some of the concepts here (or maybe I don’t understand them), and I think that he overpersonalizes his discussion by framing it as a narrative about mostly one person, which I suppose comes with the territory in journalism. It’s still quite a good article, however.

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Nuclear Power and The Chicago Tribune

On the editorial page of the Chicago Tribune they recently wrote an article titled “Restored Faith In Nuclear Power”. This article summarizes the recent earthquake in Japan and the fact that it occurred right under a nuclear plant. Even though the plant wasn’t rated to support an earthquake, it withstood a 6.8 magnitude earthquake with only minor damage and no radiation leakage.

Next, the article talks about the fact that there is some nuclear construction occurring in the US. They cite the Tennessee Valley Authority (TVA) and the fact that they restarted the Browns Ferry Nuclear Plant in mid-May 2007 after a $1.8 billion effort, which took 5 years. Other nuclear plants on the drawing board are supposedly reducing the licensing frame to four years and construction to three years, meaning that nuclear plants could come online in seven years.

The article also mentions that the UN report on global warming mentioned that nuclear power had to be part of the mix alongside wind and renewable resources to reduce global warming. Thus, they conclude, the US can have faith in nuclear power, and left the feeling that in fact more nuclear power is on the way.

While I personally believe that nuclear power IS an essential part of our energy portfolio and that encouraging nuclear power is good for the country and our balance of trade, I think that this editorial is way too optimistic and there in fact is little hope of a nuclear power revival in the US.

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