41–50 of 540 posts
I always think that it's only a matter of time before some company with vast capital (looking at you Apple) finds their own way to set up a city/country with their own ecosystem (healthcare, transport etc.), with less bureaucracy and more efficiently.
Edit: I think Apple is only interested in medical devices.
Earlier quoted context omitted.
> Today it's closer to $18,000. Do you happen to know the sources of inflation? Are we consuming a lot more services? Are healthcare providers being paid more? Are healthcare companies getting rich?
One word answer for the rising cost of healthcare in the US: administrators. [1] [1] https://fee.org/articles/the-chart-that-could-undo-the-us-he...
Administrator salaries don't seem to explain this: https://www.statnews.com/wp-content/uploads/2016/03/ASPE1.pn...
Nor this: http://static3.businessinsider.com/image/556494646da8110d29e...
This sort of thing probably doesn't help, either: http://www.foxnews.com/us/2018/01/30/drug-companies-flooded-...
Earlier quoted context omitted.
The US healthcare system worked for the majority of people until roughly the last 15 years, and then it began failing gradually up the income ladder. So if you look more recently, the last ten years in particular, that would be the window where something like this would especially begin to matter. It wasn't done before, because it didn't make sense for large entities to bother; things have gotten bad enough that now…
> Today it's closer to $18,000. Do you happen to know the sources of inflation? Are we consuming a lot more services? Are healthcare providers being paid more? Are healthcare companies getting rich?
As the other comment noted, there has been a vast expansion of administrative bullshit cost in the system.
Pharma drug costs have gone up a lot (that's around 10% to 15% of the $1.x trillion cost problem the US has). The US is spending about ~20% of its GDP on healthcare, or roughly twice the OECD average (~70-80% more than countries like France or Belgium). That's up from 12.x% in 1990, and 14% in 2000 (that 6% representing an added $1.x trillion in cost). That 12% figure in 1990, is comparable to what nicer developed nations spend today.
US wages are high, healthcare workers typically earn far above the median (eg US nurses and doctors are very well paid), and we've hired a lot of healthcare workers in the last 20 years. The number of healthcare workers has roughly doubled since 1990 from eight million to around 15-16 million today. A near 100% increase vs a population increase of about 30% or so over that time. That is guaranteed to generate a massive cost spike for that part of the problem, and that cost isn't being distributed across a further 100% larger population base. Healthcare workers have also seen their wage growth exceed the median wage growth, they've mostly done ok. So the net cost per capita for each healthcare worker in the US, has soared.
Insurance companies have done exactly what you'd expect. They push prices as high as they can get away with, adding more cost bloat to the system.
The American diet deteriorated dramatically since ~1980. Obesity particularly soared from around the mid 1980s to 2015. That brought with it a lot of added healthcare costs, around cancer, diabetes, and so on. These people weren't/aren't dying so much as they are requiring expensive routine care for various health consequences of the obesity. Conceptually it's like the battlefield cost of having a vast number of wounded soldiers, rather than those soldiers simply dying instead; in this case the battlefield is the economy or society generally speaking.
And then the US population has aged quite a bit in the last 20-30 years. The boomer generation is going to be extraordinarily expensive from a healthcare standpoint. For now that's getting worse by the year as with most developed nations.
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> One of the benefits a profit motive brings to insurance companies is pushing back on improper billing by providers (doctors/hospitals) and negotiating lowest possible care and drug rates. The ACA requires insurers to spend 80% of the premiums they take in on direct healthcare costs for their members. Inflated billing and high drug costs are actually helpful if they want to make a nice big profit. To a point, at lea…
That only applies to the individual market, not employer insurance (small and large group. Higher medical expenses don’t help. It only creates higher premiums, which members then blame on greed. There are plenty of legitimate problems with providers, drug laws, and insurers. But insurers definitely don’t benefit from higher expenses.
AKA, 10% of 2 trillion is more than 10% of 1 trillion.
> Could this problem be attacked by a goodwill billionaire with a long-term plan? Open several private medical schools that will offer "free" med education in exchange for multi-year contracts. Open many small copycat clinics. Manufacture your own generics if possible, import whatever is cheapest, focus on things you can do cheap, be transparent about pricing, build awareness and brand. McDonaldize/Amazonize American healthcare.
I've always wondered what's stopping someone from creating a non-profit and just having people join it in order to give the non-profit ability to negotiate lower prices. I imagine there's a cost to set this up, but is that cost less than the marginal cost of each employee and the savings they would (presumably) receive if enough people joined?
Likely the fact that many of these prices are basically standardized because of CMS. Providers basically look to what the Medicare/Medicaid standard is as a benchmark for pricing.
As a provider why accept a lower price from insurance when the gov't is providing a backlog of people at predetermined prices?
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Unless these companies are also looking to enter the provider space, they will likely only competing on marginally better insurance rates.
Tragedy of the commons much? It's disturbing to see corporations occupy the vacuum US policy has left here.
Earlier quoted context omitted.
> Today it's closer to $18,000. Do you happen to know the sources of inflation? Are we consuming a lot more services? Are healthcare providers being paid more? Are healthcare companies getting rich?
One word answer for the rising cost of healthcare in the US: administrators. [1] [1] https://fee.org/articles/the-chart-that-could-undo-the-us-he...
> The three companies said they plan to set up a new independent company "that is free from profit-making incentives and constraints." I wonder if they will be setting it up as a health insurance cooperative, an organizational structure in which the primary goal is to serve its members, rather than to generate value for external shareholders: https://en.wikipedia.org/wiki/Health_insurance_cooperative It's not at all…
Newman's Own is one interesting (and successful) example I can think of that's an otherwise for-profit company acting effectively as a charity. Are there papers/books about how effective this would be in practice?
> The three companies said they plan to set up a new independent company "that is free from profit-making incentives and constraints." I wonder if they will be setting it up as a health insurance cooperative, an organizational structure in which the primary goal is to serve its members, rather than to generate value for external shareholders: https://en.wikipedia.org/wiki/Health_insurance_cooperative It's not at all…
This feels like a setup for a broader push into healthcare by these companies. The sector is still growing, Amazon is already working out the pharmacy space. "[F]ree from profit-making incentives and constraints" sounds like the strategy they've used so far to dominate sections of online retail.
