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

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#361

Post by TillE » Tue, Jan 30, 2018, 6:46 PM UTC

jedberg wrote: post #313

djsumdog wrote: post #243

Earlier quoted context omitted.

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…

Germany is one of very few countries with a robust public insurance scheme which also allows private insurance, but I wouldn't expect that to last too much longer - there's a growing consensus (57.6% in a recent poll) around the idea that receiving faster or better care because you can pay more is fundamentally unfair.

People need the health care that they need. Unless we're talking about small things like your own private bed in a hospital, there's no room in a just society for a "basic service" which does not provide the best possible care.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#362

Post by spoiledtechie » Tue, Jan 30, 2018, 6:47 PM UTC

physcab wrote: post #333

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…

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…

You might be on the West coast. Kaiser does individual therapy on the East. Maybe your company isn't willing to pay for individual...

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#363

Post by rsync » Tue, Jan 30, 2018, 6:47 PM UTC

ams6110 wrote: post #274

lallysingh wrote: post #231

Earlier quoted context omitted.

I believe OP is talking more generally about insurance (not just health). Insurance covers you for unusual unexpected large-cost events at the cost of regular, predictable payments. They are useful in capping your risk exposure. But if the events are rather certain, then the insurer can only act as a payment plan on the events. The risk is 100%, so at least 100% is priced into your premium (profits, a overhead, etc t…

Except even the 100% risk is spread over the group. So if I have some known condition that will definitely incur $10,000 in medical expenses this year, it's still possible that my premiums total less than that, but everyone's premium is a bit higher than it would otherwise be, to cover my extra costs. Even covered wellness care probably comes out a bit less than it would otherwise cost, because not everyone uses it e…

"Except even the 100% risk is spread over the group. So if I have some known condition that will definitely incur $10,000 in medical expenses this year, it's still possible that my premiums total less than that, but everyone's premium is a bit higher than it would otherwise be, to cover my extra costs."

This is why I used wellness checks and tire changes as examples - they are regular and universal.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#364

Post by stevenwoo » Tue, Jan 30, 2018, 6:49 PM UTC

balthasar wrote: post #229

noir-york wrote: post #68

Three large employers, realising that for-profit healthcare is expensive and inefficient, create a non-profit that pools healthcare and is driven by its member's interests. This is terrible if it works. Imagine if other employers want to join it. And then even more employers... and what if the scheme becomes so large and covering so much of the population that it ... gasp... looks almost like a government-run non-pro…

It does seem silly to start a health insurance company when it will only be a couple of years before we nationalize health care.

Based on the results of the last few election cycles, I think you are being overly optimistic but I hope you are right. We could not even get the Medicare age lowered to 55 because it required a super majority in the Senate and that failed when Democrats has 60 votes because there's always someone holding out, in that case Joe Lieberman. When Democrats adopted the healthcare plan advocated by conservative thinktanks into ACA/Obamacare, the conservatives moved farther to the right - every time what we see is the Democrats triangulate and the Republicans move the goal posts.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#365

Post by dv_dt » Tue, Jan 30, 2018, 6:49 PM UTC

indemnity wrote: post #347

dv_dt wrote: post #285

Earlier quoted context omitted.

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…

I think it would have been incredibly foolish and costly for your government to sign onto that provision. It's funny that the arguments seem about single or multi or hybrid public private billing arrangements here - but if you look across the national stats, all of those arrangements perform better - because a root cause that I think there are in those nations, a regulation of cost by medical experts in that nation vs efficacy of various drugs and/or procedures. The dream that somehow laymen off the street can shop for medical care like shopping for a pair of socks and that would balance the market in price or knowledge of derived value is really naive in my eyes.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#366

Post by a3n » Tue, Jan 30, 2018, 6:49 PM UTC

The beginnings of enclaves.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#367

Post by dzink » Tue, Jan 30, 2018, 6:50 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…

Kaiser is almost a monopoly in Hawaii (only a handful of providers they haven't bought). Interests can diverge when they are the sole provider for both insurance and every health need. Example: hiring practices of cheap vs competitive doctors and staff. Anecdotally every doctor and nurse I know refuses to take their family there.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#368

Post by [deleted] » Tue, Jan 30, 2018, 6:54 PM UTC

maxxxxx wrote: post #130

mrb wrote: 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…

[deleted]

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#369

Post by FroshKiller » Tue, Jan 30, 2018, 6:56 PM UTC

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.

Everyone who says, "Why should I have to pay for poor people's health care?" is opposed to economies of scale.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#370

Post by yakitori » Tue, Jan 30, 2018, 7:01 PM UTC

dawhizkid wrote: post #127

I strongly feel that what needs to be changed is employer-based healthcare itself. It is really kind of crazy, if you think about it, how closely the quality of our healthcare and the healthcare of our dependents is tied to the company we choose to be working for at the moment. If you or a dependent take a very specific expensive medication that isn't covered by a plan a new employer might offer, then you pretty much…

> It is really kind of crazy, if you think about it, how closely the quality of our healthcare and the healthcare of our dependents is tied to the company we choose to be working for at the moment.

It's insane when you think about it from a people/citizen or a rational point of you. It's great if you are a large company because you get tremendous tax breaks for providing healthcare options and of course it heavily ties down an employee to the company.

It's why companies love H1B visas. It ties employees to the company else they get deported.

In the US, our system is so geared to capital and companies that such nonsense is allowed. Anything that gives an advantage to corporations, owners, business.