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Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#441

Post by SilasX »

pmart123 wrote: post #61
bpicolo wrote: post #49

Earlier quoted context omitted.

This is something I've been thinking about for a while - what would insurance companies (and even other companies in every vertical) look like with some incentive other than profit? Paying good salaries is one thing, but doing it for the sake of external shareholders is a different case. Newman's Own is one interesting (and successful) example I can think of that's an otherwise for-profit company acting effectively a…

Perhaps Vanguard is an example of a mass mutual company that owes part of its success through its formation due to its ability to pass cost savings back to its customers in the form of lower fund fees?

My personal (unproven) theory is that the non-profit model works well for ventures that require very little entrepreneurial judgment, but poorly otherwise. Vanguard basically follows that: they mainly sell index funds, which a well-trained monkey can run.

Similarly, it makes more sense to have a non-profit coffee-buying employee group to buy coffee (at places that don't provide it for free) rather than pay a vendor to bring it in. But that's not because profit-making is an inherent drain on efficiency, but because the "judgment" that those profits are "buying" ... doesn't add much value.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#442

Post by blacksmith_tb »

hathawsh wrote: post #414
sagichmal wrote: post #401

Earlier quoted context omitted.

Why is this form of self-reliance a virtue? To me, it looks pathological; certainly not something we should collectively be working towards.

I'm upvoting you just for engaging in this conversation, even though I thoroughly disagree with you. :-) The "distributism" described above is the dream of virtually every rural community. People choose to live in rural communities because it's a little piece of heaven for them: they are surrounded by people they know, they have clean air, the earth is right beneath their feet, the stars are bright, the pace is slow,…

Wouldn't it also be possible to see that as rural residents putting on a brave face? The general trend has been towards urbanization globally for the past century or more, and relatively few young people growing up in rural communities seem to be interested in staying in them in the US[1].

1: https://www.bloomberg.com/view/articles/2017-06-20/rural-ame...

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#443

Post by rublev »

blacksmith_tb wrote: post #442
hathawsh wrote: post #414

Earlier quoted context omitted.

I'm upvoting you just for engaging in this conversation, even though I thoroughly disagree with you. :-) The "distributism" described above is the dream of virtually every rural community. People choose to live in rural communities because it's a little piece of heaven for them: they are surrounded by people they know, they have clean air, the earth is right beneath their feet, the stars are bright, the pace is slow,…

Wouldn't it also be possible to see that as rural residents putting on a brave face? The general trend has been towards urbanization globally for the past century or more, and relatively few young people growing up in rural communities seem to be interested in staying in them in the US[1]. 1: https://www.bloomberg.com/view/articles/2017-06-20/rural-ame...

Too many bad actors involved to have a clear sight. Better to start from a clean slate.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#444

Post by MertsA »

rsync wrote: post #145
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…

"The whole reason we get insurance is to avoid those high prices." But only for unpredictable, irregular events. Anything else is uninsurable. If someone sells you "insurance" for wellness checkups[1], regular, scheduled screenings ... or tires on your car ... you can be absolutely assured that they are taking from you as much, or more, in premiums than the cost of those services. What you are looking for is socializ…

This isn't quite correct for American health care. It is absolutely cheaper to pay insurance premiums than to pay directly for medical bills. The insurance company takes in more premiums than benefits that they pay out but the price that insurance companies negotiate for a procedure is dramatically lower than what you would be able to get if paying directly.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#445

Post by SilasX »

cptskippy wrote: post #54
robbiemitchell wrote: post #13

Earlier quoted context omitted.

One of the benefits a profit motive brings to insurance companies is pushing back on improper billing by providers (doctors/hospitals) and negotiating lowest possible care and drug rates. Tech-focused insurers like Oscar also invest heavily to help guide members toward better care paths, which if done well lead to better care at less expense (for both the member and insurer). Unrelated: one of the worst parts of insu…

> One of the benefits a profit motive brings to insurance companies is pushing back on improper billing by providers And one of the reasons for the most complicated billing system in the world is for-profit Insurance companies.

I think the causality flows the other way: the system being so complicated to navigate creates huge barriers to entry, which result in huge profits for whoever can navigate the whole system.

Whenever I want to feel sad, I think about how the most brilliant minds of our times are probably making a fortune at such zero sum transactions as gaming the health system and tax code.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#446

Post by rdm_blackhole »

You guys can fight how to turn your money hungry insurance companies into decent "patient caring" entities or you can do like the rest of the developed countries and adopt a basic single payer system where everybody pays for everybody and if you so which you can still purchase the best private health insurance for a couple hundred bucks a month.

Example:

For my wife and I, one insurance company has quoted us $AU600 a month for the top of the line health insurance with no deductible and very little waiting periods.

Also if we decide to not go down that road, we can go to the doctor and the hospital for free without any worries about money.

How about that?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#447

Post by adreamingsoul »

blacksmith_tb wrote: post #442
hathawsh wrote: post #414

Earlier quoted context omitted.

I'm upvoting you just for engaging in this conversation, even though I thoroughly disagree with you. :-) The "distributism" described above is the dream of virtually every rural community. People choose to live in rural communities because it's a little piece of heaven for them: they are surrounded by people they know, they have clean air, the earth is right beneath their feet, the stars are bright, the pace is slow,…

Wouldn't it also be possible to see that as rural residents putting on a brave face? The general trend has been towards urbanization globally for the past century or more, and relatively few young people growing up in rural communities seem to be interested in staying in them in the US[1]. 1: https://www.bloomberg.com/view/articles/2017-06-20/rural-ame...

That's not true. Almost every person I know in my generation is working hard to buy a piece of land in a rural community.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#448

Post by dragonwriter »

chimeracoder wrote: post #93
cptskippy wrote: post #54

Earlier quoted context omitted.

> One of the benefits a profit motive brings to insurance companies is pushing back on improper billing by providers And one of the reasons for the most complicated billing system in the world is for-profit Insurance companies.

> And one of the reasons for the most complicated billing system in the world is for-profit Insurance companies. Not really. In fact, Medicare is responsible for most of the current billing system, not private insurers.

> Not really. In fact, Medicare is responsible for most of the current billing system, not private insurers.

Medicare, Medicaid, Private Insurers, and the need for all of them to coordinate between each other all contribute significantly.

The need for all of them to sometimes coordinate with non-healthcare payers (e.g., property and casualty insurers) for some claims also adds some complications.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#449

Post by philwelch »

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…

So, for example: should the government provide free LASIK for everyone who wants it, or should they make it outright illegal to even pay for LASIK out of pocket? What about vasectomies? Abortions? What if it's something my doctor and I agree would be a good course of treatment, but the health care bureaucrats don't agree with?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#450

Post by dragonwriter »

cptskippy wrote: post #341
chimeracoder wrote: post #239

Earlier quoted context omitted.

> 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,…

> 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.

They are actually overlapping problems, since some of those private lines are Medicare Part C or D plans (and some are Medicaid managed care plans, and some are both Medicare Part C and Medicaid managed care plans.)

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