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

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#221

Post by kelnos » Tue, Jan 30, 2018, 4:38 PM UTC

weka wrote: post #209

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…

Not sure I get you. "But only for unpredictable, irregular events." But if I went into the Doctor's office without insurance, could they turn me away? The bill would be too high? We looked into ACA... but we thought that the process of switching over from AETNA to COBRA would be painless (weeks at most). So we just went through with it. We did not know it would end up like it has. The operations for insurance is a da…

I think the parent is objecting to the use of the word "insurance". By definition, insurance is a form of risk management, to protect yourself against unexpected cost or loss. You can't be "insured" for regular wellness checkups and screenings; that word just doesn't make sense there, as those are expected, regular costs. Coverage for that is more like a "health plan", which is, in reality, what we have, despite the industry's insistence on calling it insurance.

(But yes, admittedly, this is just pedantry.)

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#222

Post by ihsw2 » Tue, Jan 30, 2018, 4:38 PM UTC

nabla9 wrote: post #89

ihsw2 wrote: post #72

Earlier quoted context omitted.

Vanguard took decades to gain any traction and it was managed well enough to ensure it didn't prematurely burn out, and not only that but Jack Bogle spent his entire life evangelizing low-cost in an environment where "cost is no object" was a common mantra. Not only that but the healthcare industry has extraordinarily high financial and legal barriers to entry.

>extraordinarily high financial and legal barriers to entry. If there is a company with enough muscle to force themselves into the business, it's Berkshire.

Considering their already extensive ground in insurance and JP Morgan's financial acuity, Amazon is in good hands. I know I'm hoping they encounter some success.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#223

Post by snow_mac » Tue, Jan 30, 2018, 4:39 PM UTC

mapgrep wrote: post #176

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 l…

They're in Colorado

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#224

Post by kelnos » Tue, Jan 30, 2018, 4:39 PM UTC

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.

Most doctors in my area will charge less in cash for people who don't have insurance vs. what they charge insurance companies for the same services.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#225

Post by djsumdog » Tue, Jan 30, 2018, 4:39 PM UTC

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.

I worked in health care and saw so much money wasted. The ACA was suppose to bring the same risk factors to everyone, so you got the same premiums based on age, gender and smoking status. Big companies got big breaks for employees and the rich paid less.

This might have worked if everyone was required to buy from the market place and there were no employer plans. Obama's famous "You can keep your existing health coverage" was a terrible, terrible decision.

I watched the Medicare/Medicate group for my company and they might have complained about not getting enough money, but I really think they did. Things had fixed prices and there'd be plenty of money if BlueCross didn't spend money on advertising, useless wellness programs and shitty IBM technology.

Everyone should just get Meidcare/Medicade. The government won't control healthcare, it will just get contracted out to providers. They'll have to cut costs and not waste so much money (they waste A LOT!)

Capitalism + Health care is a failed experiment. Socialized health care does work, in every high income country that's not the United States. Australia fought against the Abbot government when they wanted to introduce copays. That's right, Australians don't have doctor co-pays (they kinda do now, but wavers are in place and the plan was effectively defeated).

The fact that the US government requires us to buy private health insurance at insane rates is absolutely insane and the Supreme Court should have struck it down. You are not a car. Your body shouldn't have a fee for existing.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#226

Post by L_Rahman » Tue, Jan 30, 2018, 4:40 PM UTC

criddell wrote: post #28

adventured wrote: post #11

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?

Healthcare companies are getting rich.

http://slatestarcodex.com/2017/02/09/considerations-on-cost-...

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#227

Post by skybrian » Tue, Jan 30, 2018, 4:41 PM UTC

OpenDrapery wrote: post #194

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.

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.

Generally speaking, insurance companies profit if they don't have to pay out, which is why they sometimes pay for prevention.

But this has other problems. Incentives are tricky.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#228

Post by collyw » Tue, Jan 30, 2018, 4:42 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.

As a European I would disagree. We have helathcare for the purpose of keeping people healthy rather than for profit. It seems to work out a whole lot better than your system in the states.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#229

Post by balthasar » Tue, Jan 30, 2018, 4:42 PM UTC

noir-york wrote: post #68

Three large employers, realising that for-profit healthcare is expensive and inefficient, create a non-profit that pools healthcare and is driven by its member's interests. This is terrible if it works. Imagine if other employers want to join it. And then even more employers... and what if the scheme becomes so large and covering so much of the population that it ... gasp... looks almost like a government-run non-pro…

It does seem silly to start a health insurance company when it will only be a couple of years before we nationalize health care.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#230

Post by kelnos » Tue, Jan 30, 2018, 4:43 PM UTC

austenallred wrote: post #117

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…

You’re right, but respectfully, in the long term, “I want this specific provider at any cost” is somewhat of an edge case. A lot of (most?) people just want good healthcare and a low cost. That’s a complex but solveable problem.

Agreed. Care continuity is certainly important, but it's not $30k-out-of-pocket important...