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Amazon, Berkshire, JPMorgan to Create Healthcare Company

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Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#521
post #361

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…

… the idea that receiving faster or better care because you can pay more is fundamentally unfair.

Is it unfair because it’s health care specifically or because of something else? Premium service offerings abound: priority mail delivery; first class passage; reddit gold; ongoing memberships or subscriptions to movie theaters, golf courses, publications, and podcasts; “freemium” model web services, and Amazon Prime.

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

Basic service and best possible care are at different ends of the spectrum for whatever good or service we’re talking about. What did you mean by this remark?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#522

Earlier quoted context omitted.

> Today it's closer to $18,000. Do you happen to know the sources of inflation? Are we consuming a lot more services? Are healthcare providers being paid more? Are healthcare companies getting rich?

As a 10 year engineer in the medical device industry I've slowly come to believe the root cause is not greed for more profit, but actually runaway altruism. All across healthcare, providers, scientists, administrators are faced with millions of tiny choices every day: should we spend more money to improve outcomes. Should we add that extra feature to this device - costs more but improves care a little. Should we use…

So by this reasoning, you're saying virtually every other country on Earth that spends less than half as much per capita as the U.S., has no such concept as medical bankruptcies, and covers a greater percentage of citizens must be LESS altruistic than America?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#523
post #361

Earlier quoted context omitted.

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…

If everyone is super, then no one is.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#524
post #456
post #298

Earlier quoted context omitted.

I've known two people who loved Kaiser until they had a serious issue. Not privy to a ton of the details, but it appears that they Kaiser is not immune to at least a divergence of interests with their patients when the figures get big.

I've heard horror stories from all kinds of people with all kinds of insurers. For example, a neighbor of mine uses California Pacific Medical in Nob Hill. It's the hospital that caters to San Francisco elite. This past year his doctors mistook skin cancer on his eye for a sty for like 6+ months. He went back several times complaining before they caught their mistake. It's too soon to tell, but that serious issue may…

EDIT: I meant CPMC in Pacific Heights (Upper Fillmore), not Nob Hill. Judging by the people coming and going, Saint Francis on Nob Hill seems to mostly serve the Tenderloin.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#525

Earlier quoted context omitted.

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 bu…

Where does it stop? If "healthcare is a right" and "food is a right" and "shelter is a right" who is going to pay for all of these services for all of these people when they have no vital need to go out and support themselves? Who's going to maintain the sewers and take care of the trash and all of the jobs that most people don't want to do?

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#526
post #21

I'm neutral on the particulars of this venture (it's probably positive). But how can anyone argue that the market is efficient when it is possible for companies that "is free from profit-making incentives" to exist? Just curious. How does this example fit into that framework?

> how can anyone argue that the market is efficient when it is possible for companies that "is free from profit-making incentives" to exist? "Commoditise your complements" is an old and true business mantra. It's the reason it's good business for Google to promote an open web or investment banks to promote mutually-owned, virtually profitless settlement & clearing organizations like the DTCC and SWIFT. Much of the ro…

Doing some research, "Commoditize your complements" (American rather than British spelling) seems to trace to Joel on Software, 2002:

https://www.joelonsoftware.com/2002/06/12/strategy-letter-v/

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#527

Earlier quoted context omitted.

The earth can't physically support the existing human population without great cooperative ventures such as the production of electricity and nitrogen fertilizer. It can't support life at anywhere close to the present day level of prosperity without additional great ventures such as transportation, medicine, telecommunications, money systems, and electronics manufacturing. All known means of operating those ventures…

By every possible quality of life metric, things have been getting better and better for humans. People have predicted the population bomb many times for hundreds of years, and every time they have been wrong. Scientists predict human population to peak in 2040 anyway. I think that we can make it till then. The world supports the current population quite well, right now.

I hope I wasn't predicting a population bomb. What I was suggesting was that the existing population level is sustained by organized human activity at a scale that can't be managed by independent individuals or small groups. Thus a proposed restructuring of society requires a credible plan for maintaining or replacing some specific activities such as the Haber process.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#528

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…

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 a fantastic plan, similar to Singapore's - they have among the best metrics for health outcomes and an inexpensive system where primary care is paid for out of HSA-like tax-incentivized accounts and catastrophic care is funded by the state. It's a fantastic meeting of markets and a giant risk pool.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#529
post #462

Earlier quoted context omitted.

While your experience might tell you that the reality is that is simply not true. You're countering a statistically sourced statement with an anecdote.

There are two actually statistics underlying the discussion here, and from my reading both points are right (though disagreeing that we're urbanizing is incorrect)... 1) Our general trend is towards urbanization, humanity is now more urban than rural, and every quality of life index shows cities give more good to more people better. 2) Millennials, hipsters in particular, in American markets with crushing real estate…

I'm totally in the camp who wants to move back to the Midwest and buy some acreage- my point was mainly that the person I responded to flat out stated that the parent commenter was wrong which is not the case.

Re: Amazon, Berkshire, JPMorgan to Create Healthcare Company

#530
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…

> distributism Thank you for giving a name to something I have been pondering a lot. I have come to this conclusion by thinking about automation and technological unemployment. If people own land, or productive tools, they can be self reliant and exist without jobs from corporations, or help from the state. Naturally people would organise as a cooperative or a market of services, exchanging services for services, bec…

It's interesting to see your thoughts on UBI, how you connect it necessarily to the state. I think this doesn't have to be the case: https://joincircles.net

I am also very much in favor of distributed, self reliant communities. Yet I want to preserve the advantages of a global linked economy.

I hope that Blockchain technology will help us to achieve this.

I tried to capture some of the thought vectors here: https://gist.github.com/AndreasS2501/2dc6c5813f5fd8abc79aad4...

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