I think one of the big ideas that is being tested out there is getting rid of the adversarial economics of insurance in general. The whole industry is basically optimizing towards paying out as little while maximizing what they can get. Such cynicism is being broken in some sectors. Like Lemonade is really trying a radical new behavioral approach.
Amazon, Berkshire, JPMorgan to Create Healthcare Company
191–200 of 540 posts
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#192Earlier quoted context omitted.
Let's tear down on the government restrictions on the sell side of the market before we champion the glory of the market. Repeal EMTALA. No patents. No certificates of need. Make Medicare and Medicaid fully opt in for providers. Create a path for additional private organizations to certify medical schools. Anyone refusing to do all that stuff and face the political consequences for it just wants to pay less taxes.
I wasn't getting as specific as "championing the glory of the market". But in a general sense, what you are referring to the "market" is really the origin of control. Who is in control over your life and decisions in it and the consequences from it ... are you in control or some other party like politicians or bureaucrats who lord and decree and impose what you can choose if you have a choice at all, which invariably…
Okay, lets start by repealing limited liability for investors.
If the government has no place simplifying the process of buying insurance (by making sure products are available, comparable and reliable), then the government has no place protecting people from legal consequences related to their investments.
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#193Here'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…
Insurance companies, by and large, are gate keepers to capital. The "best" have a lot of highly innovate algorithms, machine learning, and data collection, but they're all designed to maximize the profit of the company by accurately pricing premiums. An accurately priced premium means customers who don't their services less pay less; in effect, they're using data to increase premiums for the customers who actually us…
we're talkign about HMOs here, not Insurance Companies. There is a big, big difference.
Also, the companies aren't particularly inefficient, because that gets in the way of making profit.
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#194Earlier 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.
If you profit off sick people, are you motivated to move toward a world with no sick people? If you profit from prisons, then you need to fill you prisons. Problem is, that as a society, we should aim toward not needing prisons at all. Therein lies the rub.
If I profit off of you being sick, then I need to keep you sick.
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#195As 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 l…
Kaiser is available up and down the west coast, having completed the acquisition of Group Health last year. https://www.seattletimes.com/seattle-news/health/kaiser-perm...
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#196[deleted]
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#197Earlier quoted context omitted.
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/
I'd like to see some evidence on that because I can imagine staying with one doctor might result in some conditions not being diagnosed.
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#198When 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 :)
Im talking about totally thinking differently, not the current situation.
About having a lot of money saved....after a prosthetic implant i added up stuff. $143,000 spent on insurance since 2005. Part employer part me. Up until the prosthetic less than $5k (if that) on health. $143k is almost 3 years pay. I would have rather had it paid to me. Then i would have spent my money for my healthcare
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#199As 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 l…
They're mostly based in California, though they recently acquired Group Health Cooperative (largest healthcare provider in Washington State).
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#200Earlier 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?
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…
> The calculus of incremental value vs. cost is subconsciously seen as inhumane across the industry -- it's seen as starting down that slippery slope that ends with a "dollars per life" number which feels wrong to everyone. Nobody wants to be the person who traded someone's health for a buck.
That's not what's going on though, is it?
All across healthcare you have groups trying to provide an evidence base, and other groups trying to decide whether that evidence base means something is value for money or not. In England that's going to be NICE, in the US it's insurance companies.
The US has a serious problem of over-testing. The reason isn't because they think it improves outomes. They know it doesn't, they know it makes things worse. They over-test because it means they're less likely to get sued. The cost of the test is lower than the cost of getting sued, even though too much testing is causing harm.