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Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#261
post #139

Earlier quoted context omitted.

No, its not an edge case. If you have a rapport with a doctor/care provider, you would want to stay with them. I have a genetic disease and an endocrinologist who helps me manage it. I wouldn't want to leave that doctor, who has seen me multiple times, has my charts, understands what Im working with, and so much more.

People want to believe that their medical condition(s) are a special, one-in-a-billion mix requiring years or decades of rapport-building and conversations. That's not the case for the vast majority of people, even with very complicated medical histories and diagnoses. "Has seen me in the past" and "has my charts" are not indicative of medical efficacy. There are doctors I have rapport with, absolutely. I still have…

Wait...except the decrease in care when transferring a patient to a new doctor is the EXACT reason health care professionals say we can't put a cap on working hours and introduce more doctors to help with the work-load.

They always says it hurts the patient's care. I think there is some truth to both sides, but we'll probably never know. Too many people are making out like bandits in the current health care system.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#262
post #236

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 think they're just pocketing the difference between the market rate and what their costs are.

This is baseless and not really possible.

Insurers must spend 80% of premiums (85% for large group plans) on providing care for their insured.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#263
post #260

Earlier quoted context omitted.

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.

In retrospect this is probably what I should have done.

edit: but the thing was, I trust them to give me good advice. The HR providers. I figured, well if they haven't said anything about deferred payments, it might not be applicable to my situation so I never brought it up...

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#264
post #146
post #136

Earlier quoted context omitted.

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…

Who is going to develop AI-based diagnosis platforms if there's no profit to be made?

Single payer does not mean non-profit, providers would still be for profit.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#265

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...

Kaiser has both HMO and PPO plans, although depending on your employer you might only have access to the HMO (e.g. if they went with another insurer for the PPO).

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#266
post #7

> The three companies said they plan to set up a new independent company "that is free from profit-making incentives and constraints." I wonder if they will be setting it up as a health insurance cooperative, an organizational structure in which the primary goal is to serve its members, rather than to generate value for external shareholders: https://en.wikipedia.org/wiki/Health_insurance_cooperative It's not at all…

One of the benefits a profit motive brings to insurance companies is pushing back on improper billing by providers (doctors/hospitals) and negotiating lowest possible care and drug rates. Tech-focused insurers like Oscar also invest heavily to help guide members toward better care paths, which if done well lead to better care at less expense (for both the member and insurer). Unrelated: one of the worst parts of insu…

Not always - the other way to mitigate billing inflation is to increase premiums (which would explain the last 20 years).

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#267
A brief plug for anyone interested in starting in this space. I'm an engineer at RedoxEngine[0] where we build a system to transform the many varying forms of Healthcare data into an easy to use JSON API[1]. This has proven to reduce development time and increase the available pool of Healthcare Organizations that your product can connect with[2]. I'm pretty happy working here and seeing the types of solutions that our product enables/expedites. If you're interested in the space feel free to PM me regarding questions. It's an exciting time to be working in the rewarding field of Healthcare Technology!

0: https://www.redoxengine.com/ 1: https://developer.redoxengine.com/ 2: https://www.redoxengine.com/customer-stories

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#268
post #190

Earlier quoted context omitted.

If you want an investment you can invest, if you want insurance you can get insurance. I'm not sure why you think overpaying for insurance and getting a dividend back sounds like a great way to do both. If you pay for insurance for 40+ years you certainly got something out of it--you have been insured for 40+ years!

>> If you want an investment you can invest, if you want insurance you can get insurance. Most people used to do both at the same time and it seemed to work pretty well before Buffett came along. And there's a good analogy to your last point - someone who rents an apartment for 40 years when they could have bought an equivalently valued home two times over. They shouldn't complain when they die with a net worth of ze…

They didn't just have a roof over their head, they had a roof over their head without bearing the risk of fluctuating real estate value.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#269

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…

It's a bit of an aside, but this whole issue, the bare knuckle fight about health care brings about an interesting deeper rooted issue that clearly and uniquely differentiates the two primary perspectives; one side always tends towards the heavy handed, imposing, authoritarian approach to force things they deem self-evident as desirable or have determined to be "good" and are thereby inherently inefficient and wastef…

>and are thereby inherently inefficient and wasteful

The many healthcare systems generally described as "socialist" are more cost-efficient than the American system.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#270

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…

Your desires are mutually incompatible. Imagine you’re contracting for cloud hosting services, and you start with the premise you’re not going to switch away from your existing provider. How do you achieve cost efficiencies in that situation?
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