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Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#171

Post by greysonp »

losteverything wrote: post #158

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

I mean, you can always pay for healthcare the day you need it. It's just incredibly expensive.

And don't forget, one day you'll be old or sick, so I hope you have a lot of money saved :)

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#172

Post by tssva »

kasey_junk wrote: post #27
_m8fo wrote: post #6

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?

Kaiser Foundation Health Plans & the Kaiser hospitals are non-profits.

In my area on the individual exchange they were one of two providers available with the other being a for profit insurance company. At every level of plan the for profit had cheaper premiums, co-pays and lower deductibles.

At least in my area Kaiser also likes to centralize certain specialties at a single one of their health clinics. For instance mental health providers are only available in one location. I live in a large metro area with severe traffic issues. The clinic mental health services are provided out of may be the worse location for the majority of the service area to reach. For me an appointment would have involved a 45 minute to hour drive each way.

A couple of years ago Kaiser decided not to renew their contract with the non-profit hospital system which dominates this area and instead signed a contract with a for profit hospital system. This means there is a single hospital within a reasonable drive of me which I would be able to utilize. Even then there are 3 hospitals in the non-profit system which are closer or equal distance. It gets worse if for some reason I would have had to use the next closest hospital Kaiser will cover. There are 5 hospitals in the non-profit system that would be closer. Also the non-profit system is nationally recognized as the top or a top 5 care provider for several specialties. The for profit is not.

I have no love for Aetna, Cigna, United Health, Anthem or any of the other large health insurance companies, but Kaiser also doesn't seem to be the model to follow.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#173

Post by lotsofpulp »

rsync wrote: post #145
weka wrote: post #116

Earlier quoted context omitted.

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…

"The whole reason we get insurance is to avoid those high prices." But only for unpredictable, irregular events. Anything else is uninsurable. If someone sells you "insurance" for wellness checkups[1], regular, scheduled screenings ... or tires on your car ... you can be absolutely assured that they are taking from you as much, or more, in premiums than the cost of those services. What you are looking for is socializ…

It's rather entertaining to see the fallout of costs becoming more transparent in America's healthcare system. There is a reason why the medical field is so lucrative in the US, and it's because for decades it's been subject to extreme price obfuscation. This is great for the merchants (pharmaceuticals, doctors, hospitals, medical software providers, nurses, etc), especially for such inelastic goods such as healthcare.

Now that organizations in the US have reached a breaking point, those costs are becoming clear to the consumers and they don't like it. You're absolutely right that the term insurance is bastardized in the healthcare setting, but people will have no choice but to understand.

If people want to blame somebody, they can start with the doctors union that restricts the number of residency positions open.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#174

Post by ChrisClark »

bbddg wrote: post #106
dekhn wrote: post #12

Here's what this is about. Large successful companies contract out their health insurance and care to external companies. Most of those companies are profit centers- they provide a service, but they take a very large profit on it. Much of that profit is just waste- it's money that goes to people who aren't innovating, or providing value, just acting as gatekeepers (note: this is just my opinion, not provable fact). C…

I'd call this liberal-communism. We just have to put our trust in benevolent billionaires to solve our problems for us with no oversight or democratic controls whatsoever. The idea that this is anything but an attempt to squeeze even more money out of the system for quite literally the richest people on Earth is naive. In Ohio, 10% of Amazon employees are on food stamps[1] while Bezos is worth over 100 billion dollar…

Isn't that just conservative-capitalism? Specifically the US Republicans? Get rid of regulations, lower taxes on corporations and billionaires and put our trust in benevolent billionaires to solve our problems for us with no oversight or democratic controls whatsoever.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#175

Post by lotsofpulp »

bostonpete wrote: post #168
rsync wrote: post #145

Earlier quoted context omitted.

"The whole reason we get insurance is to avoid those high prices." But only for unpredictable, irregular events. Anything else is uninsurable. If someone sells you "insurance" for wellness checkups[1], regular, scheduled screenings ... or tires on your car ... you can be absolutely assured that they are taking from you as much, or more, in premiums than the cost of those services. What you are looking for is socializ…

Your comment seems to overlook the fact that insurance companies negotiate better rates on many (most?) services than an individual would get going at it alone. From that perspective, I think it's reasonable to say that in our current system, insurance can allow you to essentially avoid high prices even for things that are predictable/regular.

That is because providers can't refuse healthcare to someone that needs it and can't afford it, so those costs get inflated just to be able to get a fraction of it. As rsync says, it's still not insurance, it's just the ability to be part of a group large enough to negotiate pricing, and has enough credibility for providers to trust them to be able to pay.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#176

Post by mapgrep »

As some other people have mentioned below, the much lauded[1] vertically integrated health provider Kaiser Permanente started this way, as the health provider caring for the workers of an enlightened large employer, Kaiser Steel, which at the time was a massive shipbuilder for the Navy and others headquartered in California with a major presence in the SF Bay Area.

I was briefly covered by a Kaiser plan, and have a lot of old friends who are either covered, work there, or worked there, and can say people really appreciate not only the relatively low costs but also the ability to just come to one place no matter the ailment and know you'll be able to get an appointment quickly and be taken care of, and won't have to haggle to get the care you need or deal with insurance company roadblocks. To the extent there are downsides (and of course there are) they are around not being able to have your own doctor (though I do think there is an approximation of that) and overzealous cost cutting (see the kidney center scandal).

My understanding is Kaiser has not spread much beyond California due to regulatory issues.

(Interestingly, Kaiser Steel was a major setting for Atlas Shrugged.)

[1] http://www.nytimes.com/2013/03/21/business/kaiser-permanente...

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#177

Post by wbl »

prklmn wrote: post #128
adventured wrote: post #113

Earlier quoted context omitted.

Not only has Berkshire never paid dividends, as another comment noted, Buffett decided three decades ago to give all of his wealth away to the benefit of less fortunate people. What's your next premise?

I was wrong, replace dividends with stock buybacks and buying up other companies, it's the same impact on the policy holder, who will still see no financial gain from holding the policy. Did you consider that some of those less fortunate people that he donates to might be less fortunate because they've been paying into an insurance system that for 40+ years years has provided them no return?

Insurance and investment are two different things. Why combine them?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#178

Post by shadyrudy »

justjash wrote: post #100

After my wife giving birth last year, I would say there is quite a bit of room for improvement. The whole billing process is such a mess when you receive different bills from doctors, the hospital, labs, etc. It seemed like the bills rolled in for months afterward, some going through insurance and some not even being billed to insurance. Happy to have insurance after I saw the total bill, but man is it a huge headach…

It's worse if you get the surprise "Out of Network" doctor that assisted in the delivery. Nothing like getting a surprise $1,200 bill when you're sleep deprived. Long story short, we didn't have to pay any of that $1,200. But the last thing we needed with a new born was more stress.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#179

Post by cremno »

bbddg wrote: post #106
dekhn wrote: post #12

Here's what this is about. Large successful companies contract out their health insurance and care to external companies. Most of those companies are profit centers- they provide a service, but they take a very large profit on it. Much of that profit is just waste- it's money that goes to people who aren't innovating, or providing value, just acting as gatekeepers (note: this is just my opinion, not provable fact). C…

I'd call this liberal-communism. We just have to put our trust in benevolent billionaires to solve our problems for us with no oversight or democratic controls whatsoever. The idea that this is anything but an attempt to squeeze even more money out of the system for quite literally the richest people on Earth is naive. In Ohio, 10% of Amazon employees are on food stamps[1] while Bezos is worth over 100 billion dollar…

>liberal-communism

What's next? Anarcho-Capitalism?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#180

Post by rubicon33 »

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'm as much a capitalist as the next man, but lining your pockets when you're already a billionaire, at the expense of middle class, is downright pathetic.
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