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Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#351

Post by malyk »

megaman22 wrote: post #327
nowarninglabel wrote: post #251

Earlier quoted context omitted.

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…

She can wait until an incident happens and then activate cobra. You don't have to pay for it upfront.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#352

Post by IronKettle »

megaman22 wrote: post #327
nowarninglabel wrote: post #251

Earlier quoted context omitted.

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…

I think you can retroactively pay for COBRA, yeah?

You can enroll after an event and it'll be as though you had insurance the whole time. You'll have to pay for the retroactive coverage, but it's a pretty smooth way (assuming nothing happens) to avoid paying for COBRA while still technically "having coverage".

Though I think there's a time-limit on it.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#353

Post by lotsofpulp »

tmh79 wrote: post #299
lotsofpulp wrote: post #173

Earlier quoted context omitted.

It's rather entertaining to see the fallout of costs becoming more transparent in America's healthcare system. There is a reason why the medical field is so lucrative in the US, and it's because for decades it's been subject to extreme price obfuscation. This is great for the merchants (pharmaceuticals, doctors, hospitals, medical software providers, nurses, etc), especially for such inelastic goods such as healthcar…

Residency programs are more restricted by funding for residency spots, not by the AAMC. Funding is, very weirdly, provided by Medicare. It's all a tangled mess with lots of weird stakeholders, but saying "doctors are using rent seeking behavior to limit new entrants to the field" is a bit disingenuous. https://economix.blogs.nytimes.com/2013/12/17/how-medicare-s... https://www.aamc.org/advocacy/gme/71178/gme_gme0012.…

From what I've read, a lot of that is due to the prices set by the RUC:

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

https://www.aafp.org/news/practice-professional-issues/20120...

Good for the doctors though, at least they're smart enough to bargain in their own interest.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#354

Post by noir-york »

stale2002 wrote: post #346
noir-york wrote: post #77

Earlier quoted context omitted.

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.

One does not preclude the other. In European countries with a national health service you can still buy private coverage.

Incidentally, a one-size fits most plan works great for alot of people.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#355

Post by sizzle »

dkonofalski wrote: post #157
weka wrote: 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…

This echoes my experience during the mortgage crash so much it gave me flashbacks. - Bank of America messes up my loan because the person doing my paperwork was a newbie. No biggie, right? - Branch manager offers to fix the issue and prioritize it so that we can close in time. - Branch manager is unable to fix it in time so offers to pay our closing costs and re-finance the loan afterwards. - Branch manager leaves th…

How has foreclosure been? Hard to get new loans? Hope you bounce back.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#356

Post by outworlder »

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 great compared to other US providers (although that's not such a high bar).

The issue I see is that they are very reluctant to refer you to specialists even when the issue seems way over the GPs head. And they are somewhat fast-food-ish. Go in, do whatever it needs to be done quickly, then off you go.

But still way better (and cheaper) than the competition.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#357

Post by mbesto »

propman wrote: post #340
physcab wrote: post #333

Earlier quoted context omitted.

I’ve been with Kaiser for over a year after having been on One Medical which is aiming to go in the opposite direction (many small satellite offices with good tech and more personal private care). For simple, routine needs Kaiser really does shine. Easy appointments, quick, good staff. We recently had a baby through Kaiser and pre-natal and post-partum care as well as the actual delivery was a fantastic experience. M…

Agreed. Kaiser does well for the vast majority of problems and for the averafe person, but anything specific, out of the norm, or challenging Kaiser fails. You sometimes need to see someone not in network and that's the main reason for insurance. Anyone really can help treat you for common ailments, but when something unique comes it's better to have the options to see the best in the field.

This happened to my family as well. My wife broke her ankle and is an avid amateur sports nut. She wanted to go see a top sports doctor (KP has none) and couldn't get KP to cover any of it. To pay out of pocket was anywhere between $20k-$30k. We ended up flying to the UK because it was cheaper and she had a trusted top tier sports injury surgeon she knew there.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#358

Post by mLuby »

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…

Agree that Kaiser is great for normal cases.

That said, it is terrible when traveling. It's almost as if they don't expect people to travel for more than a week at a time.

What do people do during long term travel?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#359

Post by thefourthchime »

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…

That's pretty cool. I grew up with Kaiser, going to the one-stop-shop hospital in my youth. I didn't think much of it, it was icky and grey.

It wasn't until adulthood and having to navigate the fragmented world we have now, I realize how nice that was.

That and it was cheap(ish)!

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#360

Post by rdtsc »

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…

Second that. I was covered by Kaiser for more than 10 years. It really is a great provider. You just show up to a clinic and everything is there - all the specialists, doctors, labs all under one roof. They have all the records already, everyone in the chain can see each others notes, lab results etc.

Yeah with my plan I don't have access to outside doctors, so far however I didn't need them.

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