Will hospital costs go the way of CEO pay?

Clearly legislators have been reading my blog and were touched by the story of my healthcare emergency this past 4th of July. My experience embodied the every-man and moved our government to action. The result? Mandated price transparency for hospital services. Yes, hospitals nationwide are now required by federal law to reveal their once-secret master price lists. However, while I know our Senators were trying to help a millennial out with out-of-pocket costs, there’s a real risk of unintended consequences. In fact, prices might just go up.

As a parallel, let’s take the case study of CEO pay in the 1990s. In 1993, the Democratic Congress under Bill Clinton passed a change to tax law that capped companies’ tax deductions for executives’ compensation to $1 million per executive per year. Concurrently, starting in 1992, The SEC began requiring standardized disclosure of compensation in proxy statements in hopes of making it more difficult to disguise pay that didn’t incentivize managers, or was excessive. Yet this move to transparency and incentives alignment backfired; by 2000, the average CEO pay had nearly quintupled to $19 million.

What explains this massive increase? In short, the practice of benchmarking CEO pay. CEO base pay was never cut, because CEO pay became increasingly based on benchmarked lists limited to top-paid CEOs in that field. This selection bias in comparison sets resulted in a rising tide for all CEO packages. At the same time, because the tax amendment did not penalize performance-based pay, compensation committees started offering a growing number of stock options as an incentive to CEOs. Options could only become valuable as the companies performed well. And in the late 90s, as the stock market rose and pushed all options “in the money”, total compensation rose in lockstep.

Will a similar comparison bias happen for medical costs? Or will payors temper rising costs with their buying power? Only time will tell.

Christmas Tree Arbitrage Redux

Does the fact that you are on the corner mean that you can corner the market?

Previously, on Christmas Tree Arbitrage …

Since our 2016 article on Christmas tree arbitrage opportunities in local markets, we added the backstory of supply & demand based on planting and harvest cycles affected by prior recessions. This year, we peal back two more layers of the onion: the entry of e-commerce into the market, and the temporal aspect of pricing.

Decades ago Christmas tree shopping in New York was simply a story of street corner competitors. Then came the chain stores, like Whole Foods and Home Depot. And now, enter stage left the biggest player of them all: Amazon. Yes, this season e-commerce is in the Christmas tree market.

Amazon is testing a new thesis on tree shopping: delivery to your door trumps walking to the corner. Aesthetic items used to be squarely in the “try before you buy” category, which only brick and mortar can provide. But our consumer behaviors continue to evolve with the proliferation of e-commerce options, and Amazon thinks the time is now to give e-trees a try.

As Christmas tree prices have remained somewhat elevated following last year’s shortage, Amazon’s pricing of $109 + free delivery is actually a steal! Whole Foods is playing an even more competitive pricing game (likely riding the Amazon wholesale cost advantage), with pricing starting at $35 for a 6-foot tree on Black Friday Weekend. Compare this to the guy on the corner selling $120 trees, and it may be worth the extra avenue of carrying making your husband carry your freshly cut pine – and it’s an excuse to walk off the turkey!

But perhaps you want to optimize for distance walked more than price, and are interested in supporting tree farmers directly. In that case, you can also save some money by buying your tree from your corner vendor in mid-to-late December, rather than early December, when tree demand is highest.

Personally, even at ~20% off, I’m not convinced that buying a Christmas tree blind is a better experience than bundling one up that I’ve examined, checked the moisture levels of, and chatted with a farmer about. I want to know the sustainability policy of his or her farm, and that my tree is locally sourced, 100% organic, free range, cruelty free, and fair trade. I want to be reassured that it had a loving upbringing with a good family. And even if Amazon got all that right, if they are really serious about the e-tree game, I’d want a generous return policy, so that I can order three trees in different sizes, compare them, and return the extras.

Happy tree shopping!

I was in stitches: the most American 4th of July

As I was bleeding out on the pavement, I reached for my iPhone to check my insurance app. Maybe someone was having a sale on stitches this week, ideally someone close by. However, because it was the 4th of July (a typically injury fraught holiday), it seemed like surge pricing was in full effect. $75 just to have a look. Thus began the mental calculus many Americans are all too familiar with. Do I really need stitches anyway? I mean maybe I could get by with a bandaid… a really big bandaid.

At this point, I’m usually tempted to open Tinder and start swiping until I match with a doctor (or at least a medical student). I’m in no position to fight temptation. Even at $16 for a cocktail, it’s cheaper than urgent care.

Now I’m not going to say I was biking while intoxicated, but I just started this new starvation diet where you don’t eat anything for the first 36 hours, then you’re allowed 6 almonds for the next 72. Perhaps I was a little light headed, but definitely still in control. I can handle my almonds!

Just my luck, I matched with Dr. McDreamy, sitting right in the closest urgent care center.

Me: Hey, you busy?
Doctor: I am at work right now, but this guy isn’t getting any better no matter what I do. Sup with you?
Me: I’m having the most American of 4th of Julys. You really a doctor?
Doctor: Yep
Me: Pop quiz! How would you treat minor abrasions and multiple epidermal lacerations on the left leg?
Doctor: Umm…I usually start with drinks
Me: Great! What kind of alcohol ya got? Rubbing? 😉
Doctor: Wow, it’s like you know me.
Me: Well, I’d love to get to know you more. In fact, I am heading over to you right now.

I hobbled my way over, credit card in hand. In the end I wound up with a rather large bandage. I’m sure it will be fine. Happy 4th!

Urban Dictionary for business terms

In chatting with folks from engineers to analysts, I’ve realized not all business terms are widely known, and so I’ve made an Urban Dictionary for a few common concepts below.

Impressions

An internet ad that has made first contact, but did not penetrate the attention bubble. For example, when I buy a television on Amazon, suddenly the internet gets the impression that that it’s the start of a collection of 55″ flat screen TVs.

CAGR 

Not to be confused with a kegger. During my MBA, I was very confused when I showed up for the Delta Sigma Pi party. 

CAGR stands for compound annual growth rate, i.e. the smoothed, average rate of growth over several years (like a bikini line after waxing). 

CAC (Sponsored by Blue Apron)

Customer acquisition cost. This is how much you’re willing to bribe someone to try your product. Think all those Blue Apron coupons you get in the mail, basically paying you to try it. 

ARPU

Did the bribes work? How much is each sucker customer spending? That amount is your average revenue per user.

VC Discount

The VC Discount is the amount of venture capital money a consumer burns through by happily accepting all the CAC offers without becoming a loyal customer. This is calculated as follows:

For example, you may buy a $10 per month MoviePass to buy one $15 movie ticket per month. With no theater subsidy, that’s a 33% savings (1 – 10÷15)!

Deliverable

No, it’s not a pizza. A deliverable is a thing that your client or manager swears to you, in a contract signed in blood, is precisely what they want and is *very important*. You then work on the project for weeks or months, countering with your own blood, sweat, and tears. Maybe you even miss a couple of your kid’s baseball games. And as soon as you deliver it, they smile and nod, and when you leave, they put it in a drawer, never to be spoken of again.

 

The Slow Shipping Movement

Had it really only been five days? It had felt like aaages (and by ages, I mean at least a week), as I wondered where my special edition collectable bobble head set was. And then it dawned on me, this company must be part of the Slow Shipping Movement! After all, why do I need those bobble heads in two days? Slow Shippers know customers will appreciate items more once they arrive because of the delayed gratification.

Like the Slow Food Movement, Slow Shipping gets you to appreciate where your products are coming from, the “ingredients” of what are being shipped to you.

I wrote in my gratitude journal that evening, still awaiting my package, that I am grateful for all the hands that have touched this unique product, to deliver it to my shelf.

Airport yoga: the basics

Long weekends like President’s Day can woo us to long flights to the sunshine. And to be in good form for the flight and your vacay, getting your zen on can get you in the right frame to handle the most primal of human settings: the airport gate waiting area. Below are a few simple moves that can be achieved with your travel essentials, including your phone and your luggage.

Upward iPhone

While you’re crafting your last #hashtag before boarding, make a gentle back arch, chin uplifted at a 30° angle, arms gently curved in half circles, holding your phone screen towards your face.

Luggage Lunge

Taking a wide stance, bend your right knee, with your right foot pointed outward, and lengthen your left leg, with the left foot pointing forward. Use your roller luggage handle to stabilize.

Listening Tree Pose

As you desperately crane to listen to sporadic announcements — in case they are for your flight — take a moment to re-center by balancing on one foot, one hand cupped to ear and one hand in prayer position.

Weekend Warrior 1

While waiting to board the plane, take a wider then hip distance stance. Place your hands slightly above your hips, and breath deep.

This may deter antsy travelers vying for overhead space from edging in front of you. Move forward at a regular pace, trusting that line-cutters will experience bad karma from observant flight attendants.

Snack Stretch

As the stewardess offers you a snack, accept with the outside hand (the one closest to the window), giving you an opportunity to rotate your torso and have a cross-body arm stretch.

Remember before you board to take each waiting opportunity to get that blood flowing and expand outward before you crunch into an economy seat.

Oh my God: Solar system re-branding

Mars, Pluto, who are these people anyway? Certainly they don’t resonate with a Millennial audience, who is more into astrology than into Catholicism. With Elon Musk launching Teslas into outerspace and making steps to relocate us to Mars, our solar system is attracting more public attention than it has in decades – which is why it’s time to makeover the Milky Way brand. It’s time for the old Gods to step aside and to make way for the new. It’s time to re-name the planets.

Old and busted New hotness Explanation
Mercury Flash The fast messenger Mercury has a perfect analogue in the vaguely entertaining Netflix series character and DC Comic hero Flash.
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Venus Black Widow The goddess of love Venus is well represented by Black Widow, fem fatal, who can always get the Hulk to regain his cool.
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Earth Gaea Earth is the one planet that never got a god-based name…and yet the Greek goddess of the Earth Gaea is hip with the hippies and comic fans of today.
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Mars Iron Man Mars is red because it is made of – you guessed it – iron! Also, Tony Stark was an arms dealer, so only fitting that he takes the place of the Roman God of War.
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Jupiter Thor Both thunder gods. Enough said.
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Saturn Black Panther Saturn was the god of generation, dissolution, plenty, wealth, and liberation. I’d say the king and protector of Wakanda is a great fit, especially with his bad-ass body guards sporting protective neck rings, just like the fair planet.
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Uranus Superman The Greek god personifying the sky should swap with the today’s god of the sky.
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Neptune Aquaman The newer sea god has more extensive powers thanks to the blessing of Poseidon, the Greek analogue. #better
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Pluto Loki Pluto had us fooled for years, but now we know it’s not a planet. But we can give it an honorary name change to Loki, the trickster god.

You might be asking yourself why these are all comic book heroes instead of religious gods. It’s because we know the origin stories of Superman and Iron Man better than we know the stories of our greatest religious texts. As Batman producer Michael Uslan put it, “superheroes are the logical descendant to Norse, Egyptian and Greek mythology”. We watch them on the big screen, read about them in our free time, take academic courses on them, and discuss them with our friends. It’s a central piece of modern culture, and soon, that culture could be extended into outer space. There’s a clear co-marking opportunity here between Marvel and SpaceX.

All squirrels are Eagles fans

Strolling through the city of Brotherly Love one winter weekend, I marveled at the grand success of a certain invasive species in the city where they were first introduced*. Yes, I’m talking about the grey squirrel. I’ve never seen one cross a street, yet there they are, in every park, perfectly content to play squirrel tag and scout for acorns on what they must think of as “their block”. And yet, as much as they seem to be home bodies, they are in every park in the entirety of the North East. So how did they get everywhere? My theories abounded:

1. They first made it to New York, and if you can make it here, you’ll make it anywhere

2. They traveled what must have been wooded superhighways and, eventually, got paved around

3. They were lured by acorn trails until they posted up in the urban backyards of gentry

Well, none of these guesses seem too far off the mark based on Gizmodo’s historic summary: they were a cute house pet until a few got loose, and people stuffed them fat, so much so that not only did they multiply, but they tumbled out of trees under the gravitational pull of their burgeoning middles. The habit never fully got shaken in some places *cough* Boston Commons *cough*. 

Most squirrels are too cagey for direct engagement these days, but still a playful touch to our manicured urban nature encounters.

*Yes, it all started in Philly, which is why all squirrels are Eagles fans.

Can Walmart beat Instacart?

It’s been fascinating to see Walmart level up from bargain bin to bleeding edge, as they entered the e-commerce race against Amazon. Their acquisition of Jet.com and expansion into e-grocery delivery were only the start. Their latest announcement left me beaming with hope for the future of online grocery shopping, as they step up as that someone to save me from my Instacart woes. This is Star Trek level next horizon tech, deployed for our shopping delight. Drum roll please….select your own produce via 3D imaging!

Okay okay, this may not sound as thrilling to you who have no trouble getting to a supermarket any given day. But if you’ve lived in an urban supermarket desert before, you know exactly what I’m talking about. You’ve tried FreshDirect and gotten a bruised $2 tomato. You’ve tried the Instacart route, where they had 90%+ accuracy on your first order, but your second order was half missing or substituted with “equivalent foods”. SPAM IS NOT HAM! GRADE A EXTRA LARGE EGGS ARE NOT THE SAME AS ORGANIC FREE RANGE VEGETARIAN GRASS FINISHED EGGS! AND DRIED CRANBERRIES…well, actually, those are all the same.

I think we all want food to taste good and not be wilted and on its way out when it arrives to our kitchen. When the patent clears and the tech is rolled out, I will be there to test it out, in the hopes that it is the harbinger of a brave new grocery world.