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Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#231

Post by lallysingh »

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 believe OP is talking more generally about insurance (not just health). Insurance covers you for unusual unexpected large-cost events at the cost of regular, predictable payments. They are useful in capping your risk exposure.

But if the events are rather certain, then the insurer can only act as a payment plan on the events. The risk is 100%, so at least 100% is priced into your premium (profits, a overhead, etc take it over 100).

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#232

Post by xapata »

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'd say that healthcare is just one of the fields where bureaucratic incompetence is horrifying. There are many others, like the legal system confusing two people with the same name in the same town.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#233

Post by jdpedrie »

lotsofpulp wrote: post #175
bostonpete wrote: post #168

Earlier quoted context omitted.

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.

AFAIK that only applies to hospital emergency rooms. Your local doctor certainly can refuse service if you can't pay the bill.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#234

Post by csours »

skellera wrote: post #159
csours wrote: post #118

Earlier quoted context omitted.

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 somewhe…

My comment is about publicly traded competitors to this new company. I suppose I could have been more clear.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#235

Post by kelnos »

nojvek wrote: post #136
Spoom wrote: post #115

Earlier quoted context omitted.

I think in healthcare, there is a problem with profit as a motivation, at least insofar as the ability to receive care. I think healthcare professionals should be paid, and paid well. But a for-profit company (or whether or not one can pay the premiums or deductible of any insurance company) should not be a gatekeeper to whether or not one can receive care at all. Inevitably, someone will be left out in the cold, or…

Single payer healthcare is the best soln. Agreed, However I can’t see it working more than a presidential term. America is too politically unstable. What i’d love to see is a commercial business having vertical integration. Insanely cheap basics like X-rays, mris, and other checks. Heavy use of AI based diagnosis confirmed by doctors, and a big insurance pool where profits go back into scaling healthcare. Basically c…

> Single payer healthcare is the best soln. Agreed, However I can’t see it working more than a presidential term. America is too politically unstable.

I'm not too sure about that. It's taken an entire year for the GOP to start to actually succeed at chipping away at the ACA, and they have legislative and executive control. If we could get sweeping reform in a more favorable political climate, something not plagued with the implementation issues the ACA has labored under, it might stand a chance. The next administration might find it politically untenable to take it away if it actually works well.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#236

Post by e40 »

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…

Kaiser is no longer a low-cost provider. They actually are quite expensive. We go through a very large group to get a better rate but it's still much higher than many of the other options that we have in our plan.

When you look at how Kaiser is structured, they should be cheaper. I think they're just pocketing the difference between the market rate and what their costs are.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#237

Post by hinkley »

ingsoc79 wrote: post #199
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 mostly based in California, though they recently acquired Group Health Cooperative (largest healthcare provider in Washington State).

They’ve been doing a big ad campaign in WA. Now I understand why.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#238

Post by seanwessmith »

bigtones wrote: post #219
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…

I'm with Kaiser Permanente (switched from a PPO) and have been for two years and I absolutely agree with your comment - in SF they have brand new world class facilities in the dog patch neighborhood near me and I can book and see a doctor and orthopedic specialist and get an xray and scan in the same day and in the same building, and be about $30 out of pocket all in. That is awesome health care.

I'm new to the area and have Kaiser. Are you talking about UCSF Medical Center at Mission Bay?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#239

Post by chimeracoder »

cptskippy wrote: post #214
chimeracoder wrote: post #93

Earlier quoted context omitted.

> And one of the reasons for the most complicated billing system in the world is for-profit Insurance companies. Not really. In fact, Medicare is responsible for most of the current billing system, not private insurers.

Medicare is relatively simple compared to most insurance companies and their rules. Insurance providers write custom lines of business for employers per state and allow those employers to customize the coverage however they like. This happens annually with revisions done to exclude or include coverage as the employer dictates. Insurance companies, and employers, come up with byzantine rules for what's covered, when i…

> Medicare is relatively simple compared to most insurance companies and their rules.

As someone who's actually had to deal with this complexity and implement software to facilitate it, I can assure you that Medicare is not at all simple, by any stretch of the imagination. It's not even standard or consistent within Medicare within a geographical region, even if you limit the scope to Part A and Part B, excluding coverage provided under Part C and Part D.

> Insurance companies, and employers, come up with byzantine rules for what's covered, when it's covered, where it's covered, who is allowed to provide care, prerequisites before approving coverage, what brand of products are permitted in treatment, and on and on.

This is exactly what Medicare itself does. The private insurers generally structure their terms in ways that are similar to what Medicare does. They're not identical, but it's not like Medicare is some haven of simplicity by itself that the private insurers complicate. Medicare itself is unbelievably complicated and abstruse by itself.

> There are entire industries dedicated to maintaining rules management engines specifically for validating policies, coverage, and claims.

Yes, that's true. And that would be true even if you only looked at Medicare patients.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#240

Post by weka »

kelnos wrote: post #221
weka wrote: post #209

Earlier quoted context omitted.

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…

Ah, I understand - thank you.
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