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

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#251

Post by nowarninglabel » Tue, Jan 30, 2018, 4:56 PM UTC

e40 wrote: post #236

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.

I'm downvoting you because you stated this as if it is a fact for everyone. We're in a small group plan and paying about the same for Kaiser as we are for Blue Shield, not "much higher". So, I think here's it's more "your mileage may vary."

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#252

Post by djsumdog » Tue, Jan 30, 2018, 4:56 PM UTC

didgeoridoo wrote: post #8

_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?

Blue Cross Blue Shield is a 501(c)(4) nonprofit. Doesn’t seem to help.

Many BlueCrosses (they're not one company, they're all independent) are _non-for-profits_ which is totally different from a _non-profit_ or 501(c)(3). They can still lobby as a non-for-profit and the whole model is pretty much weird legal bullshit anyway.

Also another reason you couldn't start a big non-profit is because insurance companies are limited in reach by state/region. Sadly, that's one of the few things keeping them in check. If that regulation was removed, you'd see all the Blues and other companies start to merge into only two to three mega companies, similar to cell phone providers.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#253

Post by philwelch » Tue, Jan 30, 2018, 4:57 PM UTC

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…

Also, the number of employees these three companies have, put together, mean that setting up a non-profit health provider and using it to provide employee coverage saves them money in their normal businesses.

Amazon might decide to make their own networking hardware or their own power generation for their datacenters to save money, but they spend more money on headcount than on datacenters, and a huge chunk of the headcount expense goes to health insurance companies.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#254

Post by ataturk » Tue, Jan 30, 2018, 4:57 PM UTC

djsumdog wrote: post #225

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.

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 cove…

How high are your taxes in your socialized medicine nation? What are the knock-on effects of those high taxes in terms of economic stagnation, poverty, etc? I am so sick of the "but muh socialized medicine rocks" while others are paying for your problems and having their mobility curtailed by YOU without any acknowledgment regarding the real situation.

In the US we have historically enjoyed economic mobility and very loose class structure. That corporations have gamed the system is something that needs to be addressed. But to have prosperity and real freedom means that we aren't working via "collective" rights and aren't just a bunch of dumb Matrix cucks fooling ourselves like Europeans seem to be.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#255

Post by guelo » Tue, Jan 30, 2018, 4:58 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…

I'm with Kaiser and my favorite thing compared to the PPOs I've been with in the past is the integrated IT health records. Any doctor, specialists, ER, can see my whole history of ailments and drugs and lab test results. When my doctor orders up a specialist or a pharmacy I don't have to re-explain anything, it's all in the system. I'm sure it helps reduce medical errors.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#256

Post by barneygumble742 » Tue, Jan 30, 2018, 4:58 PM UTC

rvo wrote: post #167

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 wonder if we could collectively use civil disobedience and refuse to pay for healthcare and insurance until major changes are made to the system. Non violent civil disobedience. Essentially a strike against the system.

You could until someone gets sick and needs medical services, hoping they don't go bankrupt due to their lapsed coverage due to non-payment.

The biggest problem I see are the costs. The healthcare industry can't even tell you why costs differ on so many levels of services. The industry isn't transparent and they'll fight this because it's too profitable for them.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#257

Post by dekhn » Tue, Jan 30, 2018, 4:59 PM UTC

all_blue_chucks wrote: post #249

bigtones wrote: post #219

Earlier quoted context omitted.

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.

Is it an HMO? Because those can bankrupt you if you go out of network...

It's a Health Plan. People go out of network in Kaiser all the time- basically, once Kaiser's default system can't handle you (complex organ transplants, advanced rare cancers, etc), they send you to a place like UCSF, and have negotiated the cost structure.

There's no guarantee KP won't bankrupt you, but it seems better than most.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#258

Post by loco5niner » Tue, Jan 30, 2018, 5:00 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.

> “I want this specific provider at any cost” is somewhat of an edge case

Not really. I want someone I can trust. For my primary care needs, I have established trust with someone and know their capabilities, their business practices, and their character. I don't want to roll the dice with someone new when I can still go to them.

Example 1: My primary care provider(been seeing him for 10 years.

Example 2: My dentist (been seeing him or his predecessor for 30 years)

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#259

Post by limaoscarjuliet » Tue, Jan 30, 2018, 5:00 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…

I love Kaiser. One stop shop for most things, easy, efficient, unified records. Highly recommended!

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#260

Post by sjg007 » Tue, Jan 30, 2018, 5:01 PM UTC

wolfgang42 wrote: post #241

fred256 wrote: post #149

Earlier quoted context omitted.

That's the way COBRA works though: you have 2 months to elect it, but if/when you do, you have to pay premiums starting from the moment you lost your original coverage (and have retroactive coverage).

The way COBRA works is that they can just start giving you coverage whenever they feel like finally getting their act together?

No, Cobra rules are all defined in Federal law. The OP could have gotten care at the time and asked the doctors to defer billing until the insurance resolved (or just submitted to the insurance company anyway and followed up later). If the doctor/hospital balks you can show them your Cobra paperwork to confirm it. But yes you have to pay the premiums.