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

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#381

Post by woolvalley » Tue, Jan 30, 2018, 7:46 PM UTC

criddell wrote: post #135

adventured wrote: post #43

Earlier quoted context omitted.

It's a little bit of everything. As the other comment noted, there has been a vast expansion of administrative bullshit cost in the system. Pharma drug costs have gone up a lot (that's around 10% to 15% of the $1.x trillion cost problem the US has). The US is spending about ~20% of its GDP on healthcare, or roughly twice the OECD average (~70-80% more than countries like France or Belgium). That's up from 12.x% in 19…

> The boomer generation is going to be extraordinarily expensive from a healthcare standpoint. When I log in to check my 401(k) status, there's a button that will tell me my projected income and expenses down the road. Today, I'm 47 and spend very, very little on healthcare. However, when I'm 87, they project I will be paying more than $10,000 per month for healthcare. How is that possible?

Large singular expensive events will make it average out to 10k per month?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Post by collyw » Tue, Jan 30, 2018, 7:48 PM UTC

pc86 wrote: post #146

nojvek wrote: post #136

Earlier quoted context omitted.

Single payer healthcare is the best soln. Agreed, However I can’t see it working more than a presidential term. America is too politically unstable. What i’d love to see is a commercial business having vertical integration. Insanely cheap basics like X-rays, mris, and other checks. Heavy use of AI based diagnosis confirmed by doctors, and a big insurance pool where profits go back into scaling healthcare. Basically c…

Who is going to develop AI-based diagnosis platforms if there's no profit to be made?

Who is going to sequence the human genome unless its for profit?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Post by weka » Tue, Jan 30, 2018, 7:54 PM UTC

ethagnawl wrote: post #155

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…

As someone who's on the same path as you were -- and has similar needs -- this is very concerning. Have you been able to find a workable alternative or are you still stuck with AETNA?

Stuck with Aetna as they have lowest rates. Blue Cross was $200 per month more.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Post by bbddg » Tue, Jan 30, 2018, 7:55 PM UTC

stale2002 wrote: post #337

bbddg wrote: post #106

Earlier quoted context omitted.

I'd call this liberal-communism. We just have to put our trust in benevolent billionaires to solve our problems for us with no oversight or democratic controls whatsoever. The idea that this is anything but an attempt to squeeze even more money out of the system for quite literally the richest people on Earth is naive. In Ohio, 10% of Amazon employees are on food stamps[1] while Bezos is worth over 100 billion dollar…

Squeezing money out of the system by paying less money to health insurance providers? Are you really going to argue that for profit insurance providers are more deserving of that money?

No I would argue for a single payer system like Medicare for All.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Post by weka » Tue, Jan 30, 2018, 7:58 PM UTC

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…

That sucks. I hope you bounce back...

I don't understand why it should take days to "update" a system. Now, I now next to nothing about how their current system works but information updated should not take so long.

The insurance industry needs a technological overhaul but I doubt it will happen.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Post by whataretensors » Tue, Jan 30, 2018, 8:00 PM UTC

djsumdog wrote: post #243

Someone1234 wrote: post #216

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…

Tieing insurance to employers is yet another way to limit class mobility. Want to start a company? Better be young, healthy, and lucky.

It's also a huge reason people don't want transparent health records, even in the cases where it would help automate discovery and prevention of disease.

I don't think state-based healthcare is the correct abstraction either. It involves dealing with a central organization that is too big to fail. What happens when they screw something up? What do corrupt regulations look like when lives are at stake?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Post by moorhosj » Tue, Jan 30, 2018, 8:01 PM UTC

odonnellryan wrote: post #62

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…

I feel Buffet and Bezos have the technical capacity and certainly the capital to tackle this issue. They can't fix the entire HC market, but they can have a great start.

The most impactful thing would be price transparency. In no other industry do you agree to purchase something without knowledge of the cost.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Post by jedberg » Tue, Jan 30, 2018, 8:02 PM UTC

TillE wrote: post #361

jedberg wrote: post #313

Earlier quoted context omitted.

> 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 p…

> there's no room in a just society for a "basic service" which does not provide the best possible care.

Unfortunately health care is still a finite resource, and you can't give everyone the best care. You either give some the best care and everyone else good care, or you give everyone pretty good care, but no one gets the best care.

Each has its merits, but my personal feeling is if no one gets "the best care", then we as a society will forget how to give such care, and medical innovation will become stagnant.

There is a reason that the health systems with at least some private participation (USA, France, Germany) also have the most innovation. We need a balance so there can still be a motive for innovation.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Post by noir-york » Tue, Jan 30, 2018, 8:03 PM UTC

stale2002 wrote: post #376

FroshKiller wrote: post #369

Earlier quoted context omitted.

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

If the US only allowed one grocery store to exist, that would have economies of scale as well. Shouldn't we then give everyone "food insurance" which you pay for with taxes, and then are able to use that food insurance to get food from the store for free? (well, not really free, paid for by your taxes). You'd pay a predetermined amount of money no matter what you got from the store, but your options would be limited…

Government provision does NOT stop the private sector from providing options. It is not an either government OR private. But both. Your example does not exist anywhere, nor is it what it is being advocated.

To be realistic your example would be as follows: what if the US provided a grocery store that provided the basic necessities, free at the point of provistion and paid for by common taxation. People are free to buy the nice wine from the private provider next door BUT if you fall on hard times and you need to put food on the table, the rest of your fellow citizens help pay to make sure you, your partner, and your children have food to eat, and retain a semblance of human dignity, until you can get back on your feet and pay taxes that provide for someone else who needs help.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Post by bradlys » Tue, Jan 30, 2018, 8:05 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…

I don't know the kind of therapist you're going to but I was able to still see my therapist after I changed over to Kaiser. You might want to contact yours and ask if they're under the Beacon Health options plan. There are sometimes roundabout ways to get it done and I managed to do such.