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Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#311
post #108

Earlier quoted context omitted.

Given that Buffett pledged to donate 90% of his wealth to charities, I'm not sure you can characterize him as "mainly interested in lining his own pocket."

To me he is a character like Gates, Rockefeller or Carnegie. Ruthless, ever greedy businesspeople who get as much as they can out of business at any cost. Then they give a big part of it away. The question is whether the health care thing is part of the making money activities or part of the giving away activities. You can always hope for the best so let's see what happens. Looking at the American health system I am…

Why do you think this? His public and private actions generally seem to support the idea that he is ethically grounded, and I'm unaware of questionable behavior at any point in his earlier career. But I'm not that old, so I don't know who he was in the 70s.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#312

I've long wondered how we've allowed insurance companies to operate as public, for-profit entities—it's a complete conflict of interests. Hopefully this deal creates a ripple effect non-employees of these three companies can benefit from.

> how we've allowed

Personally, I've always wondered why we blithely accept having incredibly expensive shit services and coverage dictated to us.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#313

Earlier quoted context omitted.

I have a choice of exactly two health insurance companies because that's who my employer selected for me. Both are for profit companies, with Aetna just posting record profits, and we see our premiums rise year upon year. But beyond me, the fact that someone working minimum wage, unemployed, or at a startup using the Obamacare exchange pays more than an executive at a fortune 500 makes no rational sense. That's becau…

This is what was talked about in the book "Redefining Health Care." The employer based model is totally broken. What you're describing is more open capitalism in health care where everyone is on an open playing field. I use to really believe in this at one point years ago, even when working in Health Insurance. Today, I'm not even for this compromise. I think it should be taken out of our taxes in single payer. Insur…

> People don't pay individually for private security/police. We don't pay for fire.

Sure they do. Rich people hire private security all the time. Heck, not-rich people do it too. Like your local Chuck E Cheese who hires a security guard on Friday night.

Same with fire protection. There are plenty of private fire protection companies.

Everyone gets those basic services paid for out of their taxes, but some people want more than basic service, and there is nothing wrong with that.

The OPs system would work great and you could modify it simply enough to account for your system too -- everyone pays a health tax, which is then redistributed as an HSA payment to every American, setting a base level of funding.

I'm actually a big fan of single payer, but not because of the social impacts, only because of the ease of administration aspects. But if you did OPs system and made sure everyone could participate, it would probably work just as well, because there would need to basically be a health payment cleaning house to make it work.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#314

Earlier quoted context omitted.

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.

Is there any private non-university health chain in the country that does mental health well? Every contact I've seen with any acute mental health care system --- except at the University of Michigan --- has been a catastrophe.

Go Blue!

(Hope you’re feeling better)

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#315

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...

If you voluntarily go out of network for non-emergency care, then yes, you pay a ton. If you have an emergency and go to an out of network ER, that is still covered (at least for plans purchased on CoveredCA) because of provisions in the Affordable Care Act. The billing may be a logistical challenge, but it should not bankrupt you!

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#316

Earlier quoted context omitted.

I mean, you can always pay for healthcare the day you need it. It's just incredibly expensive. And don't forget, one day you'll be old or sick, so I hope you have a lot of money saved :)

Im talking about totally thinking differently, not the current situation. About having a lot of money saved....after a prosthetic implant i added up stuff. $143,000 spent on insurance since 2005. Part employer part me. Up until the prosthetic less than $5k (if that) on health. $143k is almost 3 years pay. I would have rather had it paid to me. Then i would have spent my money for my healthcare

> $143k is almost 3 years pay. I would have rather had it paid to me. Then i would have spent my money for my healthcare

What would you do in the unfortunate event that you required medical treatment that cost 10x your annual pay (a real possibility)?

Absent an insurance policy, who would you expect to pay for that? Or would you instead expect your employer to pay you (and everyone else) the maximum theoretical health care costs you might incur? That's not possible in any system.

The point of shared risk pools is to protect people against such extreme outlier costs, and you've been the beneficiary of other people keeping up their end of that contract.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#317

Earlier 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.

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.

Insurance companies are more like gyms, actually.

They profit much more if you pay them money but never use their service.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#318

Earlier quoted context omitted.

I mean, you can always pay for healthcare the day you need it. It's just incredibly expensive. And don't forget, one day you'll be old or sick, so I hope you have a lot of money saved :)

Im talking about totally thinking differently, not the current situation. About having a lot of money saved....after a prosthetic implant i added up stuff. $143,000 spent on insurance since 2005. Part employer part me. Up until the prosthetic less than $5k (if that) on health. $143k is almost 3 years pay. I would have rather had it paid to me. Then i would have spent my money for my healthcare

What if instead... You still paid the money... But it was actually an investment fund like vanguard. If you get sick it pays, it also negotiates cheaper rates for prescription, procedures, copays. If you stay healthy you get most of it back plus interests minus broker fees as retirement when you enter Medicare.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#319
post #255

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.

They were the first 'big' client of Epic Software. Many other hospital systems around the US now use Epic, and have similar features.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#320

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…

But to be real here, the main motivation for creating this new venture is employer cost. Some people might not be aware that the vast majority of large employers in the U.S. that offer health insurance are self funded (i.e. they collect premiums from themselves/employees and take on all the insurance risk), so anything they can do to lower any direct/indirect cost with plan administration, claims, drug cost (big one)…

I’ve personally sent Jeff Bezos an email to take on more for-purpose capitalism.

Something can be good for the bottom line and good for society. It’s not one or the other!

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