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02/06/19

The Warm and Sleepy Anura Myth

Dr. Victor Hutchison is a herpetologist at the University of Oklahoma, a job title with an unfortunate pronunciation that probably causes him problems at parties.  No, he doesn’t study what you think he studies.  Amphibians, not sexually transmitted diseases, are his field of work. On second thought, his work might make him very interesting at a party.

In one study, Hutchison examined the ‘critical thermal maxima’ of several species in the Anura order of the Chordata phylum. Yes, he tested to see if, in fact, if you put a frog in cool water and gradually heated it up if the frog would or would not jump out.

Oh yes, this guy makes the party cook (hey, we were overdue for a really bad pun).

Fortunately, for the frogs at least, no one is testing the first half of the metaphor and dropping frogs in boiling water.  Scientists all agree that would not go well unless the animal’s legs are being used in a Cajun dish.

However, the core of the analogy doesn’t hold up.  According to Dr. Hutchison’s research, ‘As the temperature of the water is gradually increased, the frog will eventually become more and more active in attempts to escape the heated water.’

The legend is a lie, the frog is not stupid and eventually hops out of the pot.  The next time some dolt uses this overwrought analogy in your meeting, smack them with intellectual superiority.

We bring this up because the water is getting really warm and the frog is not happy about it.

A few years ago, some researchers published a measure of healthcare affordability in an article in JAMA.  Their Healthcare Affordability Index was calculated by simply dividing the average cost of employer-provided family health insurance by median household income. 

Sure, you can take issue with this measure (e.g. what about out of pocket spending?), but it is valuable because of its straightforward nature than can be calculated by a 4th grader, which also means there is a 50/50 chance it can also be understood by members of Congress.

More than half of Americans get their coverage through their employer. Additionally, these rates are negotiated, not dictated by the government, so this is a pretty fair proxy for what is really happening.

The study notes that in 1999, the index was 14.2%.  Year over year increases took it to around 25% in 2008.  The public concern on affordability was, in part, what put President Obama in the White House.

The index jumped dramatically in 2011 and hit a peak of 31.4% in 2014.  The good news is it came down almost a point over three years, ending 2017 at 30.6%.

The bad news…2018 was 31.5%, a new record.  A family policy cost $19,616.  Median income was just over $61,000. 

Rising denominator + flat numerator = index moving higher.  That is just math.

The frog – voters, employers, the 3,145 people running for the Democrat nomination – is getting restless.

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ALN

Tim Coan, ALN’s CEO, writes an insightful and witty blog three times a week about a variety of topics relevant to independent physician practices.

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