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.
Cancer care at Kaiser was outstanding. They may be spending the money on extra staffing and facilities, not just pocketing it. The only place where I believe Kaiser falls short and gives the impression of pinching pennies is mental health care.
Amazon, Berkshire, JPMorgan to Create Healthcare Company
281–290 of 540 posts
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#282Earlier quoted context omitted.
For the doctor, a great benefit of being cash only is you don't have to do billing, a non-trivial task.
I don't disagree, but I observe that if the interests of getting the lowest cost were aligned with the insurance company, and if the complexity of billing was a significant cost factor, it should be well within the capabilities of the insurance company to simplify the billing (by simplifying the requirements) in order to lower overall costs. And yet here we are :-)
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#283Earlier 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.
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
#284Earlier 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.
You generally can't negotiate in advance though, because most providers seem unable or unwilling to tell you what anything is going to cost.
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#285It'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 had the same unfortunate experience that in angers me to even think about it. - I leave my last employer on July 21, 2017 - My old employer rols me off system on last day of July 2017 - On June 2017, they switch HR providers from TriNET to Namely and now the payment processor is Discovery Benefits and the Dental/Vision are now in Guardian. (So it went from Aetna to Aetna/Guardian and two other companies). Since my…
Edit: And great that there might be a new value conscious private competitor out there - but I'd note that all those other developed nations that are individually, collectively, and vastly outperforming our health system all have some form of government control on drug and procedure prices. And a single private company would be very hard pressed to replicate the negotiation leverage of a government. I'd also note that I'd trust JPMorgan about nil to be concerned about customer value over company profits. Other nations have a health system, and at the end of the day we have a health market.
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#286Earlier quoted context omitted.
>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
#287As 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…
Ditched my BlueShield PPO for Kaiser and costs went down dramatically. There's tons of costs to be saved in healthcare and glad to see the private sector making an effort.
Good for everyone else, I guess. :/ I ended up moving back home where the government covers my treatments.
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#288I always think that it's only a matter of time before some company with vast capital (looking at you Apple) finds their own way to set up a city/country with their own ecosystem (healthcare, transport etc.), with less bureaucracy and more efficiently.
Company towns are not a new thing: https://en.wikipedia.org/wiki/Company_town Your idea was first attempted in the 1880's :)
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#289Earlier quoted context omitted.
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.
The downside I was hinting at is that as a patient, cutting costs isn't always what you want. If it means more prevention or paying less, it's good. Otherwise it'll probably mean worse service.
Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company
#290Earlier quoted context omitted.
Hearing the report on Bloomberg news earlier today. Isn't this just for the 900k employees and isn't it just focusing on wearable tech? It sounded more like fitbit with cloud services than insurance.
>It sounded more like fitbit with cloud services than insurance. If there are healthcare providers involved giving direct healthcare, there will need to be systems and development around medical records. That could easily be sold as a product to hospitals and providers outside of the AMZN/JPM/BRK company down the road. Taking a "beginner's mindset" to me sounds like they plan on writing their own stuff, except for in…