Amazon, Berkshire, JPMorgan to Create Healthcare Company • Hacker News Board

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#151

Post by superhuzza » Tue, Jan 30, 2018, 3:41 PM UTC

optimuspaul wrote: post #144

rocketpastsix wrote: post #122

Earlier quoted context omitted.

No, its not an edge case. If you have a rapport with a doctor/care provider, you would want to stay with them. I have a genetic disease and an endocrinologist who helps me manage it. I wouldn't want to leave that doctor, who has seen me multiple times, has my charts, understands what Im working with, and so much more.

I'm sorry but that does sound like the definition of an edge case to me. You have a rare situation that requires a unique solution.

I bet that health outcomes are improved with longer term patient-physician relationships - Imagine having a new family doctor every year vs. a doctor who has known you for the last 15 years.

edit: This (quite extensive and longitudinal) study would suggest that it's true. Check out the sources on the paper for other studies with similar findings:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226774/

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#152

Post by 11thEarlOfMar » Tue, Jan 30, 2018, 3:42 PM UTC

WisNorCan wrote: post #107

maxxxxx wrote: post #84

Earlier quoted context omitted.

All involved players are mainly interested in lining their own pockets. The question if this will come at the expense of patients or other players in health care.

There is nothing wrong with “lining your own pockets” as a motivation. It is the fundamental driver of capitalism and the motivation for most entrepreneurs.

I believe that insurance companies welcome legislation and regulation. It requires them to hire more people and buy more equipment and services. All of that cost then gives them added justification to raise prices, because ‘we are a public company and have a duty to return profit to our shareholders.’ All of that regulation is expensive to start with, and needs a profit on top of it.

Another true story, even with a Health Care provider and insurance company I don’t hate: after a routine visit, I had to spend more time on the phone with both of them than I spent in front of the Dr In order to have the service code corrected so the payment would count towards my deductible. The administrators I had to work with are paid employees, their costs not only have to be covered, but profitable. Very polite, capable and professional and completely unnecessary. I dare any non-American to come into our system and figure out in-network vs. out of network, co-payment, co-insurance, personal deductibles, family deductibles, lifetime maximums, deductible vs. non deductible services... and then write an App that compares plans, even within the same insurer’s portfolio and tells me which is the better plan.

Intentional value obfuscation, unnecessarily complex, adds to the bottom line.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#153

Post by pc86 » Tue, Jan 30, 2018, 3:42 PM UTC

JoeAltmaier wrote: post #148

pc86 wrote: post #143

Earlier quoted context omitted.

Doesn't it? America is unapologetically a capitalist nation with a few notable and infuriating exceptions (looking at you, ISPs). I mean if you want to make an anti-capitalist argument on a message board owned by a venture capital firm, feel free. But by definition "profit = good"

A venture-capitalist firm that's doing studies in Basic Income and its effects. So give them a little credit.

I don't think there's anything necessarily anti-capitalist about BI, especially if it could be shown that a given level of BI substituting certain social programs was more cost-effective. Increasing benefits while lowering taxes without raising the deficit or incurring debt would be a pretty easy sell to both sides of the aisle, I'd think.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#154

Post by blendo » Tue, Jan 30, 2018, 3:42 PM UTC

bpicolo wrote: post #49

jawns wrote: post #7

> 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 is something I've been thinking about for a while - what would insurance companies (and even other companies in every vertical) look like with some incentive other than profit? Paying good salaries is one thing, but doing it for the sake of external shareholders is a different case. Newman's Own is one interesting (and successful) example I can think of that's an otherwise for-profit company acting effectively a…

From ehealthinsurance.com: Kaiser Permanente is composed of Kaiser Foundation Health Plans (nonprofit, public-benefit corporations), Kaiser Foundation Hospitals (a nonprofit, public-benefit corporation), and the Permanente Medical Groups (for-profit professional organizations).

Our family have been members for over 20 years. I'd rate their health care as "good", but the real benefit is that we have NEVER had a billing dispute, because almost NOTHING is "out of network". On the rare occasions we've needed non-Kaiser health care (such as ER visits while traveling), we just give the bill to Kaiser, and they take it from there.

When the insurer owns the hospitals and contracts all the doctors, customer billing is almost friction-free.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#155

Post by ethagnawl » Tue, Jan 30, 2018, 3:44 PM UTC

weka wrote: post #116

11thEarlOfMar wrote: post #53

It's not just the cost. It's the incredible inefficiency of the operations, and, the gerrymandering of coverage. Under the ACA, I had to choose between allowing my family to continue to see their lifetime care givers, or, paying in network rates, for the full year, because the insurance company I chose gave me incorrect information when they were trying to get my business (my wife is less kind in evaluating their mot…

I had the same unfortunate experience that in angers me to even think about it. - I leave my last employer on July 21, 2017 - My old employer rols me off system on last day of July 2017 - On June 2017, they switch HR providers from TriNET to Namely and now the payment processor is Discovery Benefits and the Dental/Vision are now in Guardian. (So it went from Aetna to Aetna/Guardian and two other companies). Since my…

As someone who's on the same path as you were -- and has similar needs -- this is very concerning.

Have you been able to find a workable alternative or are you still stuck with AETNA?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#156

Post by geodel » Tue, Jan 30, 2018, 3:45 PM UTC

ceejayoz wrote: post #99

brittohalloran wrote: post #92

Earlier quoted context omitted.

As a 10 year engineer in the medical device industry I've slowly come to believe the root cause is not greed for more profit, but actually runaway altruism. All across healthcare, providers, scientists, administrators are faced with millions of tiny choices every day: should we spend more money to improve outcomes. Should we add that extra feature to this device - costs more but improves care a little. Should we use…

Good outcomes don't have to be expensive. Europe spends half what we do per-capita on healthcare, with similar (and often better) overall outcomes.

Well that's kind of truism. Good food, good education, good car, good house and so on, none of them have to be expensive, but more often than not they are.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#157

Post by dkonofalski » Tue, Jan 30, 2018, 3:46 PM UTC

weka wrote: post #116

11thEarlOfMar wrote: post #53

It's not just the cost. It's the incredible inefficiency of the operations, and, the gerrymandering of coverage. Under the ACA, I had to choose between allowing my family to continue to see their lifetime care givers, or, paying in network rates, for the full year, because the insurance company I chose gave me incorrect information when they were trying to get my business (my wife is less kind in evaluating their mot…

I had the same unfortunate experience that in angers me to even think about it. - I leave my last employer on July 21, 2017 - My old employer rols me off system on last day of July 2017 - On June 2017, they switch HR providers from TriNET to Namely and now the payment processor is Discovery Benefits and the Dental/Vision are now in Guardian. (So it went from Aetna to Aetna/Guardian and two other companies). Since my…

This echoes my experience during the mortgage crash so much it gave me flashbacks.

- Bank of America messes up my loan because the person doing my paperwork was a newbie. No biggie, right?

- Branch manager offers to fix the issue and prioritize it so that we can close in time.

- Branch manager is unable to fix it in time so offers to pay our closing costs and re-finance the loan afterwards.

- Branch manager leaves the company after our loan is completed.

- Don't qualify for re-fi because we owe more than the house is worth.

- Don't qualify for loan modification because we've never been late on our payments.

- Reported to FHA. Got in touch with local news station. Immediate response from BofA's Office of the President.

- Rep from Office of the President that was "assisting" quits 2 weeks later.

- Get another rep and they start a "forced" loan modification. Assign me another, lower rep and promise follow-up in 2 weeks.

- Repeat ad nauseum until I literally can't even and decide to foreclose because it's such a cluster.

Your last few sentences really strike a chord here. I totally feel for you.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#158

Post by losteverything » Tue, Jan 30, 2018, 3:46 PM UTC

When i think of disruption i think of uber. Rides where none could happen before.

What will their disruption be?

How about delinking insurance to healthcare. Let me buy healthcare the day i need it. And nothing the day after i dont.

No more having healthy people pay for sick people: no more young pay for the old.

Create something we cant imagine; like uber; like Facebook

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#159

Post by skellera » Tue, Jan 30, 2018, 3:48 PM UTC

csours wrote: post #118

WisNorCan wrote: post #107

Earlier quoted context omitted.

There is nothing wrong with “lining your own pockets” as a motivation. It is the fundamental driver of capitalism and the motivation for most entrepreneurs.

The problem comes from the drive for increased profit as time goes on, especially in healthcare.

Did anyone read the article? It’s going To be set up as an independent company without profit as the motive.

They know all their companies will earn more money if there is more money in everyone’s pockets. Look at how much some people are spending per year on healthcare. Someone in this thread mentioned $30k for his family in a year just for insurance. If he even saved a third of that, it’d end up being spent somewhere. A good economy benefits all those big companies. The losers in this are the healthcare companies.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#160

Post by chrisan » Tue, Jan 30, 2018, 3:49 PM UTC

enlightenedfool wrote: post #137

Everyone focuses on the wrong problem - the insurance. Why do doctors and hospitals charge exorbitantly? 10 - 25 times for the same quality, equipment elsewhere in the world. There are just not enough doctors and they take advantage of that. Let qualified doctors get in the country. When they undercut these blood suckers, prices go down.

Hospitals, at least, over charge to cover their losses with people without insurance or inadequate insurance.