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

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#321

Post by Johnny555 » Tue, Jan 30, 2018, 5:45 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.

My employer has a very good kaiser plan, basically I pay $15 for any office visit, and nothing for lab tests, etc. The total unsubsidized price is $1450/month for two people.

I don't know if $725/per person is good or not, but when I've looked around at other plan, I've found plans with far worse benefits (high out of pocket costs) for more money.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#322

Post by everdev » Tue, Jan 30, 2018, 5:45 PM UTC

pcurve wrote: post #302

colmvp wrote: post #287

Earlier quoted context omitted.

I tried applying to Kaiser and they rejected me for having a pre-existing condition which couldn't be helped given that I was born with it. Good for everyone else, I guess. :/ I ended up moving back home where the government covers my treatments.

isn't that illegal now?

That was my understanding as well.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#323

Post by kevin_thibedeau » Tue, Jan 30, 2018, 5:45 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.

> "There is no such thing as a legitimate price for anything in health care,” says George Halvorson, former chairman of Kaiser Permanente, the giant health maintenance organization based in California. “Prices are made up depending on who the payer is."

When you can game the pricing you can always just slice 80% from an ever increasing pie.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#324

Post by ethbro » Tue, Jan 30, 2018, 5:47 PM UTC

FireBeyond wrote: post #292

s73ver_ wrote: post #286

Earlier quoted context omitted.

And yet, it was groundbreaking when it was signed into law. People received refund checks after it went into effect.

And immediately after, administration costs shot up to ooh, 15-20%...

They were already above that. Especially the not-for-profits (e.g. Blues) had to scramble to get under the cap.

There was a huge amount of waste in the system. 15-20% is a marked improvement.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#325

Post by visarga » Tue, Jan 30, 2018, 5:47 PM UTC

jawns wrote: 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…

> distributism

Thank you for giving a name to something I have been pondering a lot. I have come to this conclusion by thinking about automation and technological unemployment. If people own land, or productive tools, they can be self reliant and exist without jobs from corporations, or help from the state. Naturally people would organise as a cooperative or a market of services, exchanging services for services, because they have little money and no corporate jobs. Yet they can work, so they can create a kindergarten for children of the neighbourhood, or a medical clinic, or a mechanic repair-shop, or a construction company, and so on.

By combining these skills a neighbourhood, or a city could be self reliant. In the future, with the advent of solar energy, agro-bots, 3d-printing and other empowering technologies it will be even easier to be self reliant. I see this as a better solution to UBI which depends on the state, which is corruptible and the corporations, which are greedy. People would retain their agency, unlike in the UBI scenario, where they would be wards of the state.

There is no purpose to automation that does not exist in the service of humanity at large, but only for a few. Automation must be owned by the people directly. We need to have the means of production in our hands in order to survive. There is one single job the advancement of automation can't take from us - the job of taking care of ourselves! And that's hard work.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#326

Post by greedo » Tue, Jan 30, 2018, 5:49 PM UTC

dawhizkid wrote: post #142

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…

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)…

Do you have anything to back this up? I work for an insurance provider, and this is not accurate in my experience.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#327

Post by megaman22 » Tue, Jan 30, 2018, 5:49 PM UTC

nowarninglabel wrote: post #251

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'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."

To be fair, Blue Cross/Blue Shield are usually highway robbery for terrible plans, so...

The whole thing is broken. A friend of mine is switching jobs and is going to forking over a third of her paycheck for COBRA until the new job enrolls her in their plan. Almost certainly, nothing will happen in that short time period, and she'll have wasted thousands of dollars. But if something did happen, and she didn't pay the extortion, sorry COBRA, she'd be up shit creek without a paddle and ruined.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#328

Post by stale2002 » Tue, Jan 30, 2018, 5:50 PM UTC

maxerickson wrote: post #140

23443463454 wrote: post #125

Earlier quoted context omitted.

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…

Let's tear down on the government restrictions on the sell side of the market before we champion the glory of the market. Repeal EMTALA. No patents. No certificates of need. Make Medicare and Medicaid fully opt in for providers. Create a path for additional private organizations to certify medical schools. Anyone refusing to do all that stuff and face the political consequences for it just wants to pay less taxes.

Let's absolutely do all of those things.

Healthcare is a horribly overexpensive market precisely because of those things you mentioned.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#329

Post by [deleted] » Tue, Jan 30, 2018, 5:50 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…

[deleted]

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#330

Post by dragonwriter » Tue, Jan 30, 2018, 5:51 PM UTC

gremlinsinc wrote: post #318

losteverything wrote: post #198

Earlier quoted context omitted.

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.

And if you get really sick, especially at a young age...you exhaust it and either go bankrupt or die from not getting needed care, or both, depending on exactly how providers treat people without ability to pay.