Tag Archives: health care reform

Can Small Business Survive Federal Regulation?

It has always been tough to start a business, but as Niall Ferguson points out in his excellent article “How America Lost Its Way” in the Wall Street Journal, it’s getting tougher. According to an annual survey by the World Bank, in only … Continue reading

Posted in Entrepreneurship, John's Opinions, Managing Employees, Politics and Regulation | Tagged , , , , , | 2 Comments

2 Responses to Can Small Business Survive Federal Regulation?

  1. Jeff Ostroff says:

    Totally agree with the criminal background check. not just a right but practically a necessity. who would want to hire an embezzler to be your accountant, right? we get to check everything else on a resume’ or application, but not whether they broke the law? By the time an employer does the background check they have already passed the point of a judgement based on color, race, etc if in fact they were narrow minded enough to allow that to enter into their hiring decision.

    Disagree on healthcare. everyone deserves it and while the current law sucks it was the best our representatives could come up with considering their primary objective is always political, not about the people they represent. A lot of great ideas were shot down based solely on rhetoric, unsupported assumptions and lies as facts. (BTW, i pay 90% of my employees’ healthcare)

    • John F. Dini says:

      Good for you, Jeff. I also pay the cost of my full time employees’ health insurance. I’ve been to countries where there is nothing provided for the poor, and they aren’t places I would choose to live. My problem is with criminalizing an employer’s decision to contain expenses (pointing out that the law includes provisions to cover those who don’t come under their employer’s policy, which is then paid through taxes). I have 2 part-time employees. If I had to pay their coverage as well, I’d have to pay substantially less to everyone. At the very least, I’d be less able to attract the quality of folks that currently work for me. I think those should be my decisions.

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Healthcare Reform: Managing What You Measure

The Affordable Care Act (Obamacare) expanded health coverage to millions of people. It did little or nothing to control costs, and is just the tip of the iceberg in improving the quality of care. Think about how you select your … Continue reading

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Does Your Business Need to be Leaner and Meaner? (Part 1)

I’ve been surprised by the tone of my clients’ conversations since the beginning of the year. They want to get tougher. They want to plan more. They want to find the chinks in their armor, and sharpen their weapons. These … Continue reading

Posted in Business Perspectives, Economic Trends, Strategy and Planning | Tagged , , , , , , , , | 3 Comments

3 Responses to Does Your Business Need to be Leaner and Meaner? (Part 1)

  1. Richard Pace says:

    Excellent overall assessment… looking forward to the details.

  2. Thanks for the post. Time to put this into action instead of
    just bookmarking it.

  3. craig eastman says:

    you know john, the ever present threat to small business will, as it now seems, never reduce in size. it is a constant effort to keep one step ahead of all of the negatives, including our government and the world. Looking forward to your continued input on this matter.

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Health Care Costs: Is Medicine a Market?

There is an excellent article in The New Yorker comparing the production and quality control methods of the Cheesecake Factory to certain advances in “Big Medicine.”  It focuses on the savings available from large health systems through standardization and quantity purchasing. In reality, … Continue reading

Posted in Business Perspectives, Economic Trends, Politics and Regulation | Tagged , , , | 1 Comment

One Response to Health Care Costs: Is Medicine a Market?

  1. Mimi Grant says:

    John, loved your post. Here are a few more issues to factor in: most “customers” (folks who actually pay the bill) don’t see the doctor. Why? Because these customers are typically the employers and governments that are paying the insurance premiums. Only those few truly paying “cash” for services, or those in the “individual market,” where they’re paying their own premiums, are the true customers who have a better idea of the actual cost of healthcare.

    Of course, the government, through the Affordable Care Act, is trying to give more individuals “greater access” to care. This in turn has accelerated another phenomenom: consolidation. As hospitals hire physicians directly, where they can, or indirectly through Foundations, in the states where they can’t, prices are going up – simply because hospital-based services receive a higher reimbursement.

    The other trend we’re seeing is the increase in “direct pay/concierge” physicians. With rates typically starting at $2000/year and going up from there, these doctors “limit their panel” of patients they see, a win-win for the doctor (smaller patient panel for the same or more money) and the patients who can afford this perk (easier access). The only problem is – now that the doctor’s panel has decreased, let’s say, from 3000 to 600 patients – the 2400 Former Patients need to find a new doctor. Play this out, as we hear is happening in Massachusetts, and the unattended consequence of providing for greater access, is greater expense and/or longer waits to see your same (or a new) doctor.

    Clearly we need to “bend the cost trend” to bring down the unsustainably growing high cost of healthcare. But who among the 18% making their living from this 18% of the GDP spent in healthcare (the ultimate “service” business), is going to “volunteer” to cut their compensation? After all, when you have burgeoning demand from the Medicare population (and the 10,000 Boomers a day joining it), and a society – starting with our children – increasingly prone to obesity and all its attendant ills, due to their eating/lack of exercise choices, what “magic bullet” is going to bend this trend?

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It’s Time for the Boomers to Step Up

Why I Need to Say This Three years ago I wrote an open letter titled “Last Chance to Save America” and sent it to my entire email list. It went viral, and I received almost a thousand emails in reply. … Continue reading

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