A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics • Hacker News Board

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#11

Post by jtokoph » Wed, Jun 21, 2017, 7:56 AM UTC

TuringNYC wrote: post #10

Anyone have insights on how Go Forward Health ( https://goforward.com/ ) is doing? I love their concept, to the extent I almost want to work there. However, I wonder if such services would suffer from an adverse selection problem -- their current cost of $149/mo seems almost free these days -- how do they manage high-volume users?

Just took a tour of the facility a few weeks ago. During the hour (or more?) we were there, nobody came in or out. I think their issue is just getting users at all; so high-volume users would be a great problem for them to have at this point.

They are trying to sell users on the fact that they are a tech company just as much as a medical service. But from what I saw they have a "Body scanner" (glorified scale that also gets height, O2 and pulse) and a bunch of iPads built into the walls.

EDIT: Also wanted to mention their trickery with pricing. They bill annually. The rep will tell you that they have a special promotion where you can sign up for the monthly plan if you sign up shortly after your tour. But the "monthly" plan still requires you to pay an early termination fee of 50% of the remaining annual balance.

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#12

Post by kingkawn » Wed, Jun 21, 2017, 7:57 AM UTC

oldandtired wrote: post #9

A former travelling companion (on a long distance train trip) moved from Head of R&D for an advertising agency into working in the medical technology industry. After six months or so, he returned to his former job of head of R&D at the advertising agency. When quizzed by the staff at the advertising agency as to why he came back to such a corrupt industry. His comment was that advertising were little children in term…

Straight up exploitation of people during their most vulnerable moments.

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#13

Post by fredley » Wed, Jun 21, 2017, 8:33 AM UTC

kingkawn wrote: post #12

oldandtired wrote: post #9

A former travelling companion (on a long distance train trip) moved from Head of R&D for an advertising agency into working in the medical technology industry. After six months or so, he returned to his former job of head of R&D at the advertising agency. When quizzed by the staff at the advertising agency as to why he came back to such a corrupt industry. His comment was that advertising were little children in term…

Straight up exploitation of people during their most vulnerable moments.

The free market is a poor model for providing healthcare. In an ideal free market, market forces work to find the optimum price for a product, depending on how much it costs to create the product, and how much people are willing to pay for it.

In healthcare, though, how much people are willing to pay for a product is anything, if it's the one thing they need to stay alive, or to reduce chronic pain, etc.

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#14

Post by patrickg_zill » Wed, Jun 21, 2017, 8:54 AM UTC

fredley wrote: post #13

kingkawn wrote: post #12

Earlier quoted context omitted.

Straight up exploitation of people during their most vulnerable moments.

The free market is a poor model for providing healthcare. In an ideal free market, market forces work to find the optimum price for a product, depending on how much it costs to create the product, and how much people are willing to pay for it. In healthcare, though, how much people are willing to pay for a product is anything , if it's the one thing they need to stay alive, or to reduce chronic pain, etc.

We don't have a free market in healthcare. Easily proved by looking at the artificial barriers to entry, both for products and people.

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#15

Post by pfranz » Wed, Jun 21, 2017, 9:04 AM UTC

fredley wrote: post #13

kingkawn wrote: post #12

Earlier quoted context omitted.

Straight up exploitation of people during their most vulnerable moments.

The free market is a poor model for providing healthcare. In an ideal free market, market forces work to find the optimum price for a product, depending on how much it costs to create the product, and how much people are willing to pay for it. In healthcare, though, how much people are willing to pay for a product is anything , if it's the one thing they need to stay alive, or to reduce chronic pain, etc.

It sounds like he's talking about a different problem. This is a problem with certification and regulation. What you're talking about is, "I'm bleeding and don't have time to drive to the next city over because it's cheaper." When that hospital purchased its gauze, sutures, and other equipment it wasn't under duress and theoretically could switch suppliers at any time.

Being intended for use on or inside a human body, we have higher expectations in quality and consistency. Unfortunately, these certifications can make the barrier to entry too high for good competition. Or they're locked into a supplier for whatever reason.

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#16

Post by douche » Wed, Jun 21, 2017, 9:19 AM UTC

RcouF1uZ4gsC wrote: post #2

I think there is a selection effect. It mentioned that losing some of it's large corporate customers was a big issue. When you sign up a bunch of employees that get this service through their employer, chances are good that most of the people will underutilize the service - thus you have a good profit. If you lose that, and now a lot of your customers have subscribed individually, there is a good chance that they wil…

When people have skin in the game, they make different decisions than when they are spending other people's money.

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#17

Post by [deleted] » Wed, Jun 21, 2017, 9:40 AM UTC

fredley wrote: post #13

kingkawn wrote: post #12

Earlier quoted context omitted.

Straight up exploitation of people during their most vulnerable moments.

The free market is a poor model for providing healthcare. In an ideal free market, market forces work to find the optimum price for a product, depending on how much it costs to create the product, and how much people are willing to pay for it. In healthcare, though, how much people are willing to pay for a product is anything , if it's the one thing they need to stay alive, or to reduce chronic pain, etc.

[deleted]

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#18

Post by bluecalm » Wed, Jun 21, 2017, 9:41 AM UTC

fredley wrote: post #13

kingkawn wrote: post #12

Earlier quoted context omitted.

Straight up exploitation of people during their most vulnerable moments.

The free market is a poor model for providing healthcare. In an ideal free market, market forces work to find the optimum price for a product, depending on how much it costs to create the product, and how much people are willing to pay for it. In healthcare, though, how much people are willing to pay for a product is anything , if it's the one thing they need to stay alive, or to reduce chronic pain, etc.

People are willing to pay anything for food or clothes as well. Still, free (well, at least way more free than in case of healthcare) market works decently, at least when it comes to providing cheap and decent food options.

The problem with healthcare is the opposite: there is no free market and it's impossible to compete without huge investment and even then it's sometimes still impossible (patents, long approval periods etc.).

The problem is for sure not simple but a lot of basic healthcare services could be a lot cheaper if it was easier to get in.

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#19

Post by narrator » Wed, Jun 21, 2017, 9:46 AM UTC

Animats wrote: post #8

Kaiser offers "flat fee primary care", and they do OK. But they have experience at running that kind of business.

I love Kaiser. They are so ridiculously efficient compared to all the other health care providers I've had over the years. Doctor's being salaried and paid by the hospital and the hospital chain being the insurer is really the way it should be everywhere.

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#20

Post by duncan_bayne » Wed, Jun 21, 2017, 10:10 AM UTC

fredley wrote: post #13

kingkawn wrote: post #12

Earlier quoted context omitted.

Straight up exploitation of people during their most vulnerable moments.

The free market is a poor model for providing healthcare. In an ideal free market, market forces work to find the optimum price for a product, depending on how much it costs to create the product, and how much people are willing to pay for it. In healthcare, though, how much people are willing to pay for a product is anything , if it's the one thing they need to stay alive, or to reduce chronic pain, etc.

> The free market is a poor model for providing healthcare.

No; a free market has been _proved_ to be good at providing healthcare in the US. What you folks have now is an utterly corrupt cartel.