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Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#341

Earlier quoted context omitted.

Medicare is relatively simple compared to most insurance companies and their rules. Insurance providers write custom lines of business for employers per state and allow those employers to customize the coverage however they like. This happens annually with revisions done to exclude or include coverage as the employer dictates. Insurance companies, and employers, come up with byzantine rules for what's covered, when i…

> Medicare is relatively simple compared to most insurance companies and their rules. As someone who's actually had to deal with this complexity and implement software to facilitate it, I can assure you that Medicare is not at all simple, by any stretch of the imagination. It's not even standard or consistent within Medicare within a geographical region , even if you limit the scope to Part A and Part B, excluding co…

It's not that Medicare is simple, it's not. It's that there are thousands of private insurance companies each holding thousands of lines of insurance each with their own set of rules comparably complex to Medicare.

Medicare is by volume the larges provider but size is actually a benefit because it means that it's dealt with more frequently and is more familiar to care providers.

A care provider isn't multi-regional, thus when they deal with Medicare it's mostly consistent. The interface is at least similar. However they can have 100 patients with United Healthcare and each patient will have a unique and different line of insurance.

Medicare isn't simple, it's just a small piece of a very big shit sandwich.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#342
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…

It's quite possible they are simply setting up a captive third party administrator company. All of the companies will fund health insurance which will then have benefits designed for employees and care overseen by this third entity which would be a not for profit. This entity would then have to go out and negotiate contracts with providers, drug companies, lab testing facilities etc. Given the size of these entities, they would have significant negotiating power with providers and hospital systems which could keep costs down for members.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#343

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…

KP was in North Caronlia in the 90's and if it wheren't for boneheaded mismanagement would have been completely dominant in the market there now. One of those other futures that slipped away in the night :(.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#346

Earlier quoted context omitted.

Except that it's not a monopoly. There are still options that will compete with each other.

There will be economies of scale. The bigger the pool of employees the lower the costs, so yes there are options but they could get fewer if this takes off.

Nobody opposes economies of scale.

What we oppose is being forced by the government to accept a 1 size fits all plan, and not being allowed to buy the healthcare plan we want.

It is the difference between everyone using Facebook because they like the product and the network effect, vs everyone using governmentBook because the government outlawed all competing social networks.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#347
post #285
post #116

Earlier quoted context omitted.

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…

People feel that politics are tedious, but this is exactly the reason to pay attention. Look farther than your case and systematically review overall national stats of healthcare costs in the US vs other nations. We pay the most of any developed nation, double on average other developed nations, almost triple the best run healthcare of other nations. We not only pay much much more, people die sooner and go bankrupt m…

One of the nastiest things in the failed TPP from my perspective were provisions to make illegal a government agency in my country that successfully keeps costs of medication down by forcing competition and negotiating strongly.

The numbers are small by world standards but I guess the drug companies are paranoid of this idea catching on in, say the US.

I’m sure it will be regarded as communism, but hey, it makes the market actually work for us here.

https://en.wikipedia.org/wiki/Pharmac

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#348
post #302
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?

The incident happened before the ACA, though insurers have found clever ways around it: https://www.theguardian.com/commentisfree/2016/oct/27/obamac...

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#349

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…

So basically the new company told you 'If you like your doctor, you can keep them!'?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#350
post #298

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've known two people who loved Kaiser until they had a serious issue. Not privy to a ton of the details, but it appears that they Kaiser is not immune to at least a divergence of interests with their patients when the figures get big.

I've been with kaiser my whole life. 3 open heart surgeries from 2 to 32, ongoing medical of all kinds (psych to phys). Kaiser was 2nd in the nation for cardiac care for awhile. I have had nothing but great experiences and have transferred to their Washington state system, which is basically the same, except the facilities and staff seem less sophisticated overall.
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