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

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#271

Post by hidenotslide » Tue, Jan 30, 2018, 5:11 PM UTC

skybrian wrote: post #227

OpenDrapery wrote: post #194

Earlier quoted context omitted.

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.

Normally that would be true, but under ACA profits are capped at 25% of premiums. They can increase profits only by increasing premiums, which can be justified by rising costs. Private insurance companies in America have no incentive to lower healthcare costs.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#272

Post by xiphias » Tue, Jan 30, 2018, 5:12 PM UTC

BadCookie wrote: post #246

optimuspaul wrote: post #144

Earlier 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.

Each rare disease is rare, but it is not very rare to have a rare disease. There are just thousands of rare diseases. For example, it is estimated that 6-8% of the EU population has a rare disease: https://en.wikipedia.org/wiki/Rare_disease#Prevalence

Thanks, it's great to know (also that 80% has a genetic component).

I have a rare disease (shortness of breath caused by air pollution, especially when lying down or excercising), but all pulmonology doctors are sure that I'm just depressed after the usual check-ups are unable to show the disease (and I'm not coughing which is unusual for most similar diseases). I'm trying to find blood tests and gene tests that help me find the disease I have, as I've given up on doctors. I also know multiple people with BRCA gene who weren't taken seriously by doctors before they had the gene test.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#273

Post by coding123 » Tue, Jan 30, 2018, 5:12 PM UTC

pc86 wrote: post #143

coding123 wrote: post #109

Earlier quoted context omitted.

Just because it is a fundamental whatever of capitalism, doesn't make it 'not wrong'.

Doesn't it? America is unapologetically a capitalist nation with a few notable and infuriating exceptions (looking at you, ISPs). I mean if you want to make an anti-capitalist argument on a message board owned by a venture capital firm, feel free. But by definition "profit = good"

true true, yesterday I saw someone make the argument "If popularity doesn't make something moral, what does" And on this thread it's "if capitalism doesn't make it moral, what does"..

There's an entire college course called Philosophy I that basically goes over 7 to 10 different moral compasses. The only one that seems to win out (aka the only one people remember after the class is Moral Relativism).

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#274

Post by ams6110 » Tue, Jan 30, 2018, 5:12 PM UTC

lallysingh wrote: post #231

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 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 t…

Except even the 100% risk is spread over the group. So if I have some known condition that will definitely incur $10,000 in medical expenses this year, it's still possible that my premiums total less than that, but everyone's premium is a bit higher than it would otherwise be, to cover my extra costs.

Even covered wellness care probably comes out a bit less than it would otherwise cost, because not everyone uses it even though it's covered. Some people, like me, just don't go to the doctor.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#275

Post by skellera » Tue, Jan 30, 2018, 5:13 PM UTC

csours wrote: post #234

skellera wrote: post #159

Earlier quoted context omitted.

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.

Sorry, it seemed like others were making that assumption without reading the article.

As long as this company doesn’t go public, it seems like it will be able to stay away from that. It will be extremely competitive against companies trying to raise profits.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#276

Post by otterley » Tue, Jan 30, 2018, 5:13 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...

Thus proving the inherent value of the network!

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#277

Post by dv_dt » Tue, Jan 30, 2018, 5:14 PM UTC

learc83 wrote: post #262

e40 wrote: post #236

Earlier quoted context omitted.

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.

An allowance 15-20% overhead for health insurance seems like pretty low bar for the industry...

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#278

Post by coding123 » Tue, Jan 30, 2018, 5:15 PM UTC

JoeAltmaier wrote: post #148

pc86 wrote: post #143

Earlier quoted context omitted.

Doesn't it? America is unapologetically a capitalist nation with a few notable and infuriating exceptions (looking at you, ISPs). I mean if you want to make an anti-capitalist argument on a message board owned by a venture capital firm, feel free. But by definition "profit = good"

A venture-capitalist firm that's doing studies in Basic Income and its effects. So give them a little credit.

Yes however oligarchs don't want 99% of wealth to be in the hands of the 1%. Right now its something like 40% of the wealth in the hands of the 1%. If it shifts much more they will have total war on their hands. The rich will always be encouraged to keep that number down to prevent war - which is also convenient as those efforts can make them look like our lord and salvation.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#279

Post by hidenotslide » Tue, Jan 30, 2018, 5:16 PM UTC

jonknee wrote: post #104

prklmn wrote: post #91

Earlier quoted context omitted.

It goes beyond pricing. Mutual insurance policy owners were paid dividends based on principle investment. Berkshire pays dividends to shareholders, i.e. Warren Buffet, while policy holders get nothing but insurance coverage.

> Berkshire pays dividends to shareholders Berkshire has never paid a dime of dividends to anybody.

Capital gains are equivalent to dividends, just with better tax treatment. You are "technically" correct though, which is of course the best kind.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#280

Post by dv_dt » Tue, Jan 30, 2018, 5:16 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.

It's been a while since I've worked for a company that had Kaiser as an option, but my recollection was that it was more expensive too. The quality of care in a given service region might be higher, but there's a reason that they haven't completely taken over their market.