Profiting from the coming healthcare changes?

[Bobo]

OK, so recognizing the explicit rules against revealing my political thoughts on the legislation...

Who has some ideas (traditional or fastlane) for making money off of the changing healthcare environment?

My first thought is that those with means will have less access in the future than they do currently. With what's been passed and what is proposed and an aging population there is no way to make the math work without tightening restrictions on who can get certain procedures in the future.

So, if you are 80 and want a heart transplant and have the money to pay for it, you might have to look outside the system and engage in medical tourism. That's becoming a big industry in India and other places....

Thoughts?

Disclaimer: Realllly trying to avoid a pissing contest, it is what it is and I'm trying to be pragmatic and figure out how to make up for the financial hammering that I'm about to take.

 

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[andviv]

Is this similar to this other thread?

http://www.thefastlanetomillions.co...6-medical-tourism-doctor-owned-hospitals.html

 

[hakrjak]

My idea was to short the entire market, thinking we'd be down by at least 500 by noon today, but it's actually up 50 pts right now.... WTF!?! Totally defies all logic...

I don't think you can reliably predict the fallout... i.e. today healthcare companies are UP... (Why??? Prices they can charge are about to be dramaticaly slashed, makes ZERO sense!)

People dumping money into health care stocks today might have been a knee-jerk reaction, because nobody has even read this bill yet...

Cheers,

- Hakrjak :smx4:

 

[phlgirl]

Hey Bobo -

One idea here....not really profiting from health care but the situation overall.

Live a great life on less than $200K/yr?

 

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[Rem]

Set up a secret operation connecting people with doctors going off the grid.

Not that I would do it ahem... *wink wink*

 

[hakrjak]

There are already many docs & mental health specialists who only take "private pay" clients, because it's the best money, and they don't have to deal with the billing nightmare that is Medicare & Private insurance.

The problem they have though, is finding those clients. You're probably talking about less than 5% of total patients.

It seems like 99% of docs out there do not have a head for business or marketing themselves. They have that employee mindset.

- Hakrjak

 

[faq88]

Also keep in mind that the government programs pay pretty good. Its some the insurances like United Healthcare and Aetna that are stiffing the physicians. There will be more leg work for the office staff to jump through the goverment loopholes, but I'm not sure if there will be that big of a difference in pay for the Primary Care Physicians. The ones that will see the biggest pay cut are the Surgeons and sub specialty (i.e. Dermatologist) that will have their wages cut. You will also see these specialist used less frequent because they will need a referral from a Primary Physician before the patient can even go to the specialist.

Mike

 

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[Pinnacle]

Invest in private practices. Do this alongside the doctors who are establishing them. My fiancee works for one and the quality of work, health of the patients, and cost of the services are superb solely for the fact that they are a free market family practice. It is the most glorious example of capitalism I have never seen. :icon_super:

 

[Rem]

Another option which would also be completely illegal would be to find ways to stock or manufacture a popular prescribed drug and sell it to doctors who are off the grid. Play middle man..

 

[faq88]

I'm not saying its a good idea. But most drugs are sold in Mexico over the counter. You could do this now though. THere is a huge market of people going to mexico to buy prescription medications.

 

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[MJ DeMarco]

It seems like 99% of docs out there do not have a head for business or marketing themselves. They have that employee mindset.

Ring ring, opportunity.

 

[andviv]

Why waste your time with illegal endeavors? Do something legal.

For example, back where I am from, we had something similar happened years ago. What was the outcome? Many doctors simply retired, while others saw significant decrease in their income. General/family doctors suffered the most.

Who did great? Insurance companies.

Why are they probably doing great? Cause they just got 30 million new patients, and it seems nowhere it says there will be income limitations, so their income will go up.

Who else did well? The best doctors created private practice networks and won't take insurance, so private clinics that specialized in specific illnesses or types of treatment did and are still doing great 15 years later. Creating a private clinic for Ovarian and Breast cancer. Have all the equipment and medicine all in the same location. Patients get great treatment all in the same place, while working with the same network of specialists.

 

[Bobo]

Insurance companies do well short term but since they have to cover pre-existing at healthy rates etc, they are going to raise rates resulting in government taking over.

Good short term play, what about longer term?

BTW: Spent all mother ------ day doing taxes so my general feeling right now is that DC was much cleaner when it was a Malarial Swamp. I would call them degenerate scumbags, but that is really unfair to the bags of scum out there.

PS> I may be rich according to them, but gee, I did not get the memo this year.

 

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[ZDS]

Why waste your time with illegal endeavors? Do something legal.

For example, back where I am from, we had something similar happened years ago. What was the outcome? Many doctors simply retired, while others saw significant decrease in their income. General/family doctors suffered the most.

Who did great? Insurance companies.

Why are they probably doing great? Cause they just got 30 million new patients, and it seems nowhere it says there will be income limitations, so their income will go up.

Who else did well? The best doctors created private practice networks and won't take insurance, so private clinics that specialized in specific illnesses or types of treatment did and are still doing great 15 years later. Creating a private clinic for Ovarian and Breast cancer. Have all the equipment and medicine all in the same location. Patients get great treatment all in the same place, while working with the same network of specialists.

This combined with MJ's post is pure gold staring your right in the face. Doctors are going to lose money, doctors are scared of this. They don't know how to go private? Help them, charge them, retire.

Fear is an EXCELLENT motivator, and regardless of your political view, if your a doctor, there is plenty.

 

[Russ H]

Insurance companies do well short term but since they have to cover pre-existing at healthy rates etc, they are going to raise rates resulting in government taking over.

Good short term play, what about longer term?

BTW: Spent all mother ------ day doing taxes so my general feeling right now is that DC was much cleaner when it was a Malarial Swamp. I would call them degenerate scumbags, but that is really unfair to the bags of scum out there.

PS> I may be rich according to them, but gee, I did not get the memo this year.

Sheesh, Bobo, you and the Jill-ster need to spend some time w/me and the missus.

Learn how to own a bunch of businesses. Some make money, some lose money. I'll let your smart brain figure out what happens to taxes.

Paying taxes is for high-earning E's (there, did that hurt? It was meant to) :fryingpan:

You guys are WAY too smart to do this year after year.

I really do love ya, guy. Please don't take these comments the wrong way.

-Russ H.

 

[Bobo]

Russ: Our experience with the audit taught me that it doesn't matter whether or not they are right, if they want to, they will continue to drill down and make the process so expensive and all consuming that you have two options: settle, or spend 10x as much fighting them. In the future we will be much better at the administrivia and get organized enough to hand them every shred of evidence and tell them to pound sand but we aren't there yet and don't have 30 hours per week to record every transaction, categorize it, document it and archive the evidence... we'll wind up outsourcing that.

We already have a couple businesses but that only goes so far. LOL, I only got 6 weeks of unemployment, got a new job too quickly.... had I been out 6 months I'd have been back in full entrepreneur mode but the new job is at least a very nice 'E' in terms of potential so while building the "B's" we can avoid struggling.

I'll be okay around April 16th, this time of year I get bark at the moon crazy looking at how dismissively these guys spend our money.

....and that's not political, I pretty much despise 90% of them across both sides of the aisle.

 

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[Jill]

Sheesh, Bobo, you and the Jill-ster need to spend some time w/me and the missus...

We would love to!! Like I said, I'll be out in your neighborhood over the next 5-6 months. We'll plan on coming to see ya sometime.

[Sorry to hijack. Back on topic]

 

[Russ H]

Russ: Our experience with the audit taught me that it doesn't matter whether or not they are right, if they want to, they will continue to drill down and make the process so expensive and all consuming that you have two options: settle, or spend 10x as much fighting them. In the future we will be much better at the administrivia and get organized enough to hand them every shred of evidence and tell them to pound sand but we aren't there yet and don't have 30 hours per week to record every transaction, categorize it, document it and archive the evidence... we'll wind up outsourcing that.

We already have a couple businesses but that only goes so far. LOL, I only got 6 weeks of unemployment, got a new job too quickly.... had I been out 6 months I'd have been back in full entrepreneur mode but the new job is at least a very nice 'E' in terms of potential so while building the "B's" we can avoid struggling.

I'll be okay around April 16th, this time of year I get bark at the moon crazy looking at how dismissively these guys spend our money.

....and that's not political, I pretty much despise 90% of them across both sides of the aisle.

I've worked w/the IRS. One time, the agent who was working w/me (great guy) pretty much said, "You're absolutely right. The IRS goofed (they had liened my accounts AFTER I had paid them, and would not release the $$). But I've been here for years, and I can pretty much tell you what's going to happen:

1. You fight this, and it goes on for another year or two. Eventually, someone will want to audit some of your other stuff. Which means much more time for you and your accountants.

2. I present a settlement offer to them now, and chances are pretty good they'll take it. It will be a few hundred dollars (and I would get back the $600 or so they got in the lien).

"That last scenario will take about 2-3 months, and require less than a half hours more work on your part (it was just a meeting, and signing some things).

As a businessman, of course I took option #2. It was way cheaper.

*******

I know you guys went through a really thorough and tough audit. Something like that is hard on everyone-- including the IRS guys (contrary to popular belief, IRS folks are good people-- we have some as social friends). Sad thing is, they get about as much respect as a meter maid-- or worse-- seems like lots of folks love to hate 'em.

I really, really learned a LOT in that encounter w/the IRS.

-I learned that being "right" is not as important as working out a compromise.

-I learned that (again, contrary to popular belief), some IRS agents really try to help you.

-I also learned that, like all of us, they're there to get the job done. So making it easier for them to do their job makes it easier on everyone.

You're a smart cookie, Bobo, so I'm guessing you already know all these things. I put them here more for others reading this post.

If you ever decide to post a thread called "How to work w/the IRS" that gives tips you learned, it would probably be appreciated around here.

-Russ H.

 

[Russ H]

We would love to!! Like I said, I'll be out in your neighborhood over the next 5-6 months. We'll plan on coming to see ya sometime.

[Sorry to hijack. Back on topic]

Lookin' forward to it!

-Russ H.

 

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[Jill]

Russ ~

Actually, every single point that you made are things that we eventually learned. We have actually been delightfully surprised how willing to work with us they were, once we got the accountant out of the way. He was stalling and delaying and generally being difficult, trying to convince us that we were just being harassed, etc.

Our disdain is not for the workers there, who are just doing their jobs. It is for the system that is SOOOOooooo convoluted that makes it all necessary. (.... and of course, for the whole idea of what I consider excessive taxation in general, but that's not a topic for here.)

I just read a post by Diane Kennedy 10 minutes ago about the 5 biggest mistakes in business. We were guilty of 3 out of 5:

• Mistake #2 – Undervaluing Bookkeeping Services - yup
• Mistake #3 – Lousy Record Keeping - yup
• Mistake #5 – Hiring the Wrong People - yup

So all that to say, we are just as angry at ourselves as we were at them. Lessons learned the hard way:

1. Know thyself. If you aren't good at it, and don't want to get good at it, find someone else to do it.
2. Pay for good help. It will cost you FAR less in the long run.

[Sorry for totally hijacking this thread now. Back to subject at hand.]

 

[Cat Man Du]

RussH said:

-I learned that being "right" is not as important as working out a compromise.

Boy.....that applies to EVERYTHING in LIFE!

 

[Pinnacle]

Why waste your time with illegal endeavors? Do something legal.

For example, back where I am from, we had something similar happened years ago. What was the outcome? Many doctors simply retired, while others saw significant decrease in their income. General/family doctors suffered the most.

Who did great? Insurance companies.

Why are they probably doing great? Cause they just got 30 million new patients, and it seems nowhere it says there will be income limitations, so their income will go up.

Who else did well? The best doctors created private practice networks and won't take insurance, so private clinics that specialized in specific illnesses or types of treatment did and are still doing great 15 years later. Creating a private clinic for Ovarian and Breast cancer. Have all the equipment and medicine all in the same location. Patients get great treatment all in the same place, while working with the same network of specialists.

This is capitalism at its finest. Gordon Gekko was wrong.

My point exactly about private practices, andviv. It is because they are free market practices (free from government compulsion or handouts) that they garner such success.

 

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[Bobo]

RussH said:

-I learned that being "right" is not as important as working out a compromise.

Boy.....that applies to EVERYTHING in LIFE!

Ya think? Hell, I'm married to Jill. If I insisted on being right she'd be standing over my body while reloading.

 

[Cat Man Du]

Ya think? Hell, I'm married to Jill. If I insisted on being right she'd be standing over my body while reloading.

You would fall on mine, because 'legs' had already done me in! How many of US learned this from our wives?????:huh2:

 

[Russ H]

Russ ~

Actually, every single point that you made are things that we eventually learned. We have actually been delightfully surprised how willing to work with us they were, once we got the accountant out of the way. He was stalling and delaying and generally being difficult, trying to convince us that we were just being harassed, etc.

Our disdain is not for the workers there, who are just doing their jobs. It is for the system that is SOOOOooooo convoluted that makes it all necessary. (.... and of course, for the whole idea of what I consider excessive taxation in general, but that's not a topic for here.)

I just read a post by Diane Kennedy 10 minutes ago about the 5 biggest mistakes in business. We were guilty of 3 out of 5:

• Mistake #2 – Undervaluing Bookkeeping Services - yup
• Mistake #3 – Lousy Record Keeping - yup
• Mistake #5 – Hiring the Wrong People - yup

So all that to say, we are just as angry at ourselves as we were at them. Lessons learned the hard way:

1. Know thyself. If you aren't good at it, and don't want to get good at it, find someone else to do it.
2. Pay for good help. It will cost you FAR less in the long run.

[Sorry for totally hijacking this thread now. Back to subject at hand.]

I've heard this more than once. Accountants LOVE to look like heroes (much like attorneys) so they make things worse, before getting better.

I once met a great attorney-- wasn't mine, but I shared a bad experience w/him that I'd had. His words: "Russ, when you're a hammer, everything you look at is a nail."

Was a great, great lesson. I no longer looked for hammers.

I looked for people who solved problems.

Quickly.

-Russ H.

 

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[randallg99]

has anyone been to or seen a "Minute Clinic?" These are mini-nurse's stations situated in the pharmacy chain CVS. My family has used them a couple of times (from flu shots to a bump on the head from a fall to a possible ear infection)

the convenience and expertise was unbelievable.

IMO, "clinics" and "quick fixes" are going to absolutely surge in the wake of the health care changes.

 

[GlobalWealth]

Ring ring, opportunity.

The problem I see here is with the doctors themselves. In my business, doctors are one of the best potential clients, and yet, I have not one doctor client.

Every doctor I have ever spoke to thinks he is a brilliant business person (and I have spoke to a lot of them). You cannot tell a doctor something he doesn't already know. If you don't believe me, ask a doctor.

Their education and earning power inflates their ego. They think, "I earn $500k/year therefore I am brilliant". The reality is they may be a brilliant doctor, but in most cases, completely ignorant of business. But to convince one you are a better business person will take an act of god.

With that said, this only minimizes the pool of doctors who would make good business partners, but the few you may find may make excellent partners. And the opportunity here is quite large as long as you can find the willing doctor. With the new health care bill now a done deal, you may find more willing participants.