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Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#481

Post by mbesto »

wahern wrote: post #451
mbesto wrote: post #394

Earlier quoted context omitted.

I'm not discrediting that notion. My point was to echo the sentiment that a closed-loop healthcare system has it's downsides when it hits edge cases. For the record, I pay the same for healthcare from UHC now and it would cover the $25k cost for the specialist because they're in the UHC network.

Do you pay the same as an individual or through an employer? When my wife left her job several years ago (but post Obamacare) and needed to get insurance on the open market, her Northern California Kaiser plan was roughly the same price as her employee group plan (inclusive of employer contribution). Not too long ago my sister purchased a Kaiser Mid-Atlantic plan on the open market, which was also reasonable with nea…

Not sure about open market to be honest. I'm currently on COBRA (left a FTE position that had access to both). Will let you know in 9 months :)

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#482

Post by peteretep »

bpicolo wrote: post #49
jawns wrote: 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…

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…

See also five interesting UK examples:

Healthcare: https://en.wikipedia.org/wiki/Bupa

Media: https://en.wikipedia.org/wiki/Scott_Trust_Limited

Retail: https://en.wikipedia.org/wiki/John_Lewis_Partnership

Finance: https://en.wikipedia.org/wiki/Nationwide_Building_Society

Lots of stuff: https://en.wikipedia.org/wiki/The_Co-operative_Group

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#483

Post by kevin_thibedeau »

learc83 wrote: post #471
kevin_thibedeau wrote: post #374

Earlier quoted context omitted.

There is a whole lot of backscratching with the profiteers taking their cut of the 80%. That is why we get $30 Tylenol pills under the guise of "care".

Hospitals aren't charging insurance companies $30 for Tylenol and then paying insurance companies under the table if that's what you're alleging. That's completely illegal and it's just too noticeable for them to do it large scale. The OP was making a baseless claim because they didn't know what they were talking about, and you're now grasping at straws supporting their claim for some reason.

None of the stakeholders in American for-profit healthcare have any incentive to reduce costs so everything just keeps ratcheting up. Growth can't be achieved by increasing the population of sick people so the only other option is to raise prices. The insurance companies do benefit from this. They agree to cover the inflated pricing so that their 20% cut can be bigger. If ACA permitted rational price controls this whole problem would have been reigned in.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#484

Post by dflock »

IncRnd wrote: post #433
ceejayoz wrote: post #147

Earlier quoted context omitted.

Fulfillment centers are large enough that shipping them in individual boxes may actually be the cost-effective method at times. I've also heard they play a bit of a game of tetris to fill truck trailers in a way that completely stuffs them full enough that packages don't move around.

> Fulfillment centers are large enough that shipping them in individual boxes may actually be the cost-effective method at times. You missed half of what I wrote, "instead of in 20 oversized but mostly empty boxes." The context was in a single order from a single supplier, whose product was already at the warehouse, shipping on the same date, to the same address, for the same delivery date, using the same delivery ca…

> incorrectly packing boxes, not trucks.

From Amazon's point of view, they're doing both correctly.

Their algorithm apparently optimises for packing completely filled tucks leaving the warehouse first, then optimises for minimal packaging second.

If they need a few more boxes of a particular size, to completely fill an outgoing truck, they will split some orders appropriately so that those boxes appear on the conveyor at the right moment.

This means that sometimes you receive an SD card in an A4 size box, because that was the only item that was available when they needed an A4 box to fill a truck - and the algorithm decided that the trade-off was worth it.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#486

Post by conanbatt »

noobermin wrote: post #424
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…

This is diametrically opposed to the facts. People need to stop making arguments like this about profit driven insurance when our system has the US spend the most per capita amongst modern nations with mediocre results.

Medicare is also more expensive per capita than most modern nations and its publicly funded.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#487

Post by conanbatt »

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…

> (57.6% in a recent poll) around the idea that receiving faster or better care because you can pay more is fundamentally unfair.

Gross.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#488

Post by conanbatt »

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.…

Allow foreign doctors to work in the us with a reasonable, attainable testing period of one year, and you will find no shortage of doctors in the us within the year.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#489

Post by ehead »

scribu wrote: post #417
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,…

The problem is that a small community can’t develop or even maintain advanced technology, including that required for sanitation and healthcare. So, you either choose total independence and low technology or interdependence with other groups and advanced tech.

Do you think that we'll be able to escape making this tradeoff in the future? I don't think it's unreasonable to think that sanitation and healthcare technology will advance to the point that they can be implemented in smaller communities at similar levels of quality that could be seen in big cities.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#490

Post by rhizome »

chimeracoder wrote: post #415
rhizome wrote: post #413

Earlier quoted context omitted.

This thread reads like you two are talking past each other, are you saying that cptskippy's point about individual lines on the provider side is either nonexistent or irrelevant?

> are you saying that cptskippy's point about individual lines on the provider side is either nonexistent or irrelevant? I'm saying that the marginal complexity introduced by private plans is actually quite small compared to the complexity that Medicare already creates. Furthermore, the complexity that private insurers introduce is both directly and indirectly linked to the way Medicare structures its billing and rei…

Thanks.
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