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Simplifying Economics: Understanding Healthcare Costs and Trends for Jury Profiling

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56 diapositives · 678 Views · Jul 31, 2014

Dive into the complexities of healthcare economics with Bernard F. Pettingill, Jr., Ph.D., as he breaks down medical care inflation rates, economic indicators, and the impact on jury decision-making processes. Gain insights to simplify and quantify economic data for a clearer understanding.

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  1. Reading… Writing….Arithmetic….. Simplify to Quantify Bernard F. Pettingill, Jr., PhDPalm Beach Gardens, FL October 2010 Las Vegas

  2. INTRODUCTION

  3. Outline • Background • Contact Points • Terms of Art • Presentation - Putting It All Together

  4. Juror Profile

  5. Potential Jurors Keep Estate Tax Get Rid of Estate Tax

  6. Jury • Banker • Engineer • Nurse Practitioner • Arms Crossed / Legs • Age Factor • Note Takers • Sleeper • Questions from Jurors

  7. Hooks • New Orleans • Military HS • Catholic / Ivy League College / Ph.D. • England (Foreign) • Professor (Medical School - 4 yrs) • Articles • Three Kids - Teacher / Empathy • Organizations • Court TV / Congress • Two Grandkids

  8. CREDIBILITY

  9. Jury Awareness • Posture / Clothes / Watch / Car / Truck • Body Language - Rocket Clemens; • McGuire • Out of the Box • Permission

  10. Economic Terms • Life Expectancy / Work Life Expectancy • Inflation Measures - (Local News Stories) • Medflation • Interest Rates (IRR) • Consumption Expenses • Replacement Services at Home • Paradox of Thrift

  11. CPI • Typical Market Basket • 95 Locations • Twice / Month • 211 Consumer Goods • Average Prices

  12. CPI - cont. Food & Beverages Housing Apparel Transportation Recreation Education & Communication Other Goods & Services MEDICAL CARE

  13. LOCAL NEWSPAPER

  14. Abbreviations GIGO PRN QD / BID / TID DUCES TECUM CETERIS PARIBUS SWAG

  15. Forecasting • OLD INDICATORS • AUTO • HOUSING • RETAIL

  16. Forecasting - cont. • NEW INDICATORS • WAL-MART • STARBUCKS • APPLE • NETFLIX • PAWN SHOPS • ANIMAL RESCUE LEAGUE • McDONALDS • DOLLAR STORE

  17. Rates • Discounting to PV - Recent Historic Rate • Alaskan - Total Offset • Nominal Rate / Average Rate - 25 yrs

  18. Discount Rates • JUNK DOWN • MUNIS DOWN • CORPORATE DOWN • TREASURIES RETURN RISK U.S. TREASURIES

  19. $65 M Verdict Bartow 3/2009

  20. Life Expectancy • Census Data - 2010 • Optimal Care - Based on L.E.

  21. LESSON 1 LIFE EXPECTANCY = 2.9 = 1.7

  22. Classification of Economists • Labor • Public Policy • Financial • Agricultural • Behavioral • Health/Medical

  23. Not The Same

  24. Nationalized Health Care • ENGLAND, CANADA & SWEDEN • INSURE 30+ MILLION PEOPLE - H.R. 3200 • AMERICA’S AFFORDABLE HEALTH CHOICES ACT • ELECTRONIC MEDICAL RECORDS

  25. Reasons for Cost Increases • New Technology • Waste, Inefficiency & Fraud • Drug Company R&D • Aging Population

  26. Health Care - DILEMMA • ELECTIVE SURGERY • WAITING LIST - HERNIA REPAIR • RENAL DIALYSIS • 55+ Yr Old, GREAT BRITAIN – DENIED….DEAD

  27. Organ Replacement - DILEMMA • SIXTY YEAR OLD MALE POSTAL WORKER • SINGLE MOTHER OF FOUR CHILDREN • EIGHTEEN YEAR OLD NEVER WORKED • RETIRED PALM BEACHER

  28. LESSON 2 • MEDICAL INFLATION RATES • Current (NOW) = 3.5% • Recent (10Yrs) = 4.0% • Historic (25Yrs) = 5.0%

  29. Medical CareGrowth Rates

  30. YEAR 199520002004200620082010 MEDICAL 5.1%4.3%4.3%4.2%3.8%3.5%

  31. AMERICA’S AFFORDABLE HEALTH CHOICES ACTHR 3200 ?

  32. Sequence of Experts Therapists / Nurses Treating / Evaluating M.D.’s Continuation of Care Planner / Rehab Expert Economist

  33. Continuation of CareLife Care Plan

  34. Categories of Need • Routine M.D. Visits • Therapies • ADL’s • Diagnostics • Orthopedic Equipment • Supplies • Attendant Care

  35. Treatment Patterns • Boston Vs New Haven • Large Med-Schools • Well Informed M.D.’s • Same Region Country • No Difference in Socio-Economic Status

  36. Example • White Female • Age 2.0 • Life Expectancy = 79.9 years • 24 Hour Nursing Care (HOME) • $30.50/Hour/LPN • Discount Factor = 4.0%

  37. MEDICAL INFLATION • Current (NOW) = 3.5% • Recent (10Yrs) = 4.0% • Historic (25Yrs) = 5.0%

  38. RESULTS Current: Growth Rate = 3.5%Present Value = $17.5m Recent: Growth Rate = 4.0%Present Value = $21.2m Historic: Growth Rate = 5.0%Present Value = $31.1M

  39. INTEGRITY

  40. Trial Charts • Recent Life Expectancy Tables • Medical vs. General Inflation • Sample - Goods / Services • 1940, 50, 60, 70, 80, 90’s

  41. Presentation • Earning Capacity - Cistern • Present Value - ‘Car Loan’ • Court Reporter Interruptions • 9/11 - Security • Jack Pot Justice / Home Cooking

  42. $44.9 M VerdictFort Meyers - John Romano, Esq. Florida 12/2009

  43. $11.6 M Verdict Miami, FL 4/2010

  44. $8.2 M Verdict Florida 9/2010