Global Healthcare Models

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A New Competitive Threat -or- Next-Gen Boon?

By Dr. David E. Marcinko; MBA, CMP™

[Publisher-in-Chief]

Dr. Marcinko

Did you know that some American businesses are extending their cost-cutting initiatives to include offshore employee medical benefits?

And, facilities like the Bumrungrad Hospital in Bangkok, Thailand (cosmetic surgery), the Apollo Hospital in New Delhi, India (cardiac and orthopedic surgery) are premier examples for surgical care.

Recognized Medical Institutions

It’s true!  Both medical facilities are internationally recognized institutions that resemble five-star hotels equipped with the latest medical technology. Countries such as Finland, England and Canada are also catering to the English-speaking crowd, while dentistry is especially popular in Mexico and Costa Rica.

Medical Tourism

Although this medical business model is still considered “medical tourism,” Mercer Health and Benefits was recently retained by three Fortune 500 companies interested in contracting with offshore hospitals and JCAHO has accredited 88 foreign hospitals through a joint international commission.

Assessment

To be sure, when India can discount costs up to 80%, the effects on domestic hospital reimbursement and physician compensation may be assumed to increase downward compensation pressures.

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Margin Call Models

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Characteristics of the Physician-Investor

[By William H. Mears, CPA, JD]

Generally, a brokerage firm will regulate the use of a margin account by managing the physician client’s risk, and by studying the doctor’s assets and credit history. Margin accounts at brokerage firms are watched carefully to make certain that the brokerage firm does not lose money on the individual. But, when investing on a leveraged basis, physician clients should be aware of the magnification of the market impact on their account, whether favorable or unfavorable.

Margin Investor Awareness

The physician or executive margin-investor should:

• Be sophisticated

• Be of high net worth

• Be aware of the risks

• Be told the horror stories involving leverage, and

• Be aware of the increased returns and liquidity created by margin

Model Tax Rules on Margin Transactions

Investment interest expense can be deducted as an itemized deduction by an individual physician investor only to the extent that the individual has investment income defined as taxable interest, dividends, and short-term capital gains.

Long-term capital gains cannot offset investment interest expense. To the extent that a physician-investor has excess investment interest expenses for a year, these expenses can be carried forward to future years.

If the proceeds of a loan are used to invest in tax-exempt debt, the interest expense incurred to carry that debt will not be deductible for tax purposes.

If the proceeds of a loan are used to invest in tax-exempt debt, such as municipal bonds, the interest expense incurred to carry the debt will not be deductible for tax purposes.

Assessment:

Where you aware of these tax implications on margin before reading this post?

What has been your experience with margin calls, and did you originally fit the criteria above? Please opine and comment?

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Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™