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Amazon Health

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Re: Amazon Health

#101

Post by refurb »

bambax wrote: post #66
aaavl2821 wrote: post #58

Earlier quoted context omitted.

The traditional economic view is that private, profit seeking enterprises actually offer better prices to consumers because of competition, while monopoly firms charge higher prices bc they have more market power, and government run enterprises yield lower quality products because they don't have incentive to compete on quality. India has a very competitive healthcare system that is largely out of pocket and while th…

> the US is at 17-18% while France / U.K. / Germany are around 10-12% One has to consider that many people in the US don't consume healthcare because they can't afford it (hence the lower life expectancy), whereas in other countries everybody who needs it can access it, with almost no limit. So the part of GDP represented by healthcare in the US is much lower than it "should" be; or, to put it another way, there's a…

One of the big reasons why healthcare is more expensive in the US is Americans get a lot more of it, particularly out-patient care (~150% of OECD average).

And other single payer countries certainly don't offer limitless levels of care. The gov't determines what it will pay for and nothing else. For Americans with generous insurance coverage, the care is much more limitless when you look at things like experimental treatments and the latest drugs.

Re: Amazon Health

#102

Post by refurb »

bonzini wrote: post #90
onemore2 wrote: post #72

Earlier quoted context omitted.

It's relatively easy to keep the costs low in Europe: you pay in queues and cheap health care instead of money. That doesn't mean good-or-bad automatically. E.g. giving birth by C-section is a rare event in Europe but it's very common in the US, making the "born" event very expensive on average in the US. You usually get over-testing in the US and under-testing in Europe. If you have a suspicious mole, or a woman rep…

This is complete bullshit. In many European countries you get screenings for most common tumors (bowel, for women uterus and breast) for free depending on your age. Cancer treatment and chronic disease treatment is top notch and you get it for free (you pay it with taxes), like everything else. There is no such thing as "not being covered because treatment is expensive"---I had to reread that sentence twice because I…

There is no such thing as "not being covered because treatment is expensive"

There most certainly is. Look at what the UK's cancer fund is going through. It's not unusual for NICE to say "we're not paying for that". For people with generous insurance in the US it's much more typical for the insurance company to roll over and pay for the latest and greatest due to public pressure.

Re: Amazon Health

#103

Post by refurb »

URSpider94 wrote: post #67
make3 wrote: post #48

Earlier quoted context omitted.

maybe if health insurance becomes one large monopoly, they can have enough leverage to force the health care providers to lower their prices to a reasonable level similar to that of countries where the government has that role (of being a monopoly payer, and forcing the costs to be lower by negotiation leverage)

That is what’s called “single payer” healthcare, and indeed that’s the idea.

I chuckle at the "negotiation leverage". It's not a negotiation it's the gov't setting payments by fiat. Healthcare workers in the US clearly have concerns with that.

Re: Amazon Health

#104

Post by Thinpad »

Stop telling such outlandish tales, Stop turning minnows into whales

What a piece of bull c* article.. Amazon tax amazon this amazon that and I predicted that. Really you need to get back into your complete senses that there are limits to what can be achieved by any organization. Its for articles like this that paint a rosy picture and contribute to a bubble like stock price. Can you also predict the collapse if that happens.

And to you all intelligent readers this is gonna take a long long time to change the current system. For heavens sake don't fall for this guys crap.

Re: Amazon Health

#105

Post by curun1r »

chatmasta wrote: post #84

> insurance operates best at more scale, not less: first and foremost, the larger the pool, the more risk can be spread, as well as obvious efficiency gains in administration. This may be true from the perspective of the insurance companies, but it does not mean that premiums will be lower with a larger risk pool. The global risk pool includes elderly and disabled people whose risk is paid for by healthy people. Smal…

Partially true, but with size comes negotiating power. It's not like health care or prescriptions in this country have a fixed price. Insurers help set that price and the more lives they represent, the more they can dictate to providers and pharma what a procedure, prescription, etc will cost.

Re: Amazon Health

#106

Post by [deleted] »

maxerickson wrote: post #46
simonebrunozzi wrote: post #40

Earlier quoted context omitted.

I guess you meant "staff", not "stuff". BTW, I think that the 19k/year is not representative of very large companies, which usually negotiate better terms. Still, your point stands.

Overall US healthcare spending is ~$10k per person, so it is probably at least in the ballpark.

[deleted]

Re: Amazon Health

#107

Post by bonzini »

refurb wrote: post #102
bonzini wrote: post #90

Earlier quoted context omitted.

This is complete bullshit. In many European countries you get screenings for most common tumors (bowel, for women uterus and breast) for free depending on your age. Cancer treatment and chronic disease treatment is top notch and you get it for free (you pay it with taxes), like everything else. There is no such thing as "not being covered because treatment is expensive"---I had to reread that sentence twice because I…

There is no such thing as "not being covered because treatment is expensive" There most certainly is. Look at what the UK's cancer fund is going through. It's not unusual for NICE to say "we're not paying for that". For people with generous insurance in the US it's much more typical for the insurance company to roll over and pay for the latest and greatest due to public pressure.

You are confusing treatment that is expensive with treatment that is not cost-effective. Also, the parent message was not talking about cancer but hepatitis C.

Re: Amazon Health

#108

Post by aaavl2821 »

cosmie wrote: post #69
aaavl2821 wrote: post #33

Earlier quoted context omitted.

That's interesting, hadn't heard that before. The combination of Amazon et als buying power could potentially drive out some of that inefficiency as they negotiate lower premiums and payers lower prices by cutting some of the "fluff"

It's not an argument I've seen before, but also not one I've had refuted when I put it out there. There are plenty of ways to align the incentives of insurance companies with those of the insured. But a static max ratio between medical expenses and overhead is not one of them. Because then there is literally no upside to reigning in medical expenses, as every effect of doing so is negative to the insurer. So instead…

I guess the main countervailing force against this would be pricing pressure from employers looking for better deals. I don't really know what the power balance looks like in those negotiations, but employers banding together would certainly tip the scales

It is my underatanding however that a lot of providers have payers under their thumb. A great example of this is the UCLA vs blue shield (or blue cross?) of CA a few years back. Another commenter here mentioned UPMC, another example of a mammoth local provider dictating what payers do. Sutter health in the Bay Area is a similar Goliath, and the publicly traded hospital systems (community health, HCA, etc) have made a business model out of exploiting local hospital monopolies to extract money from payers.

Payers definitely don't like this, and if they start getting squeezed on the other side from employers, it could really squeeze some payers

Re: Amazon Health

#109

Post by javier2 »

yarg wrote: post #47
sjg007 wrote: post #44

Earlier quoted context omitted.

What is the mechanism? I don't think it is realistic to assume that health care can run on employee premiums alone. In fact we know it can't b/c individual premiums are outrageous. So I don't think your premise is realistic. These billion dollar companies self insure and Buffet's companies offer reinsurance for the most costly million dollar claims. Even though they self insure, they will pay a company like Cigna a p…

Premiums are as high as they are because health care is run as a for profit industry - health care in America is orders of magnitude more expensive than in other countries. If you remove the profit motive prices will drop down towards something more reasonable, in this situation it's not unreasonable to expect that the system could be maintained with employee premiums. The cost of initialisation of services will be h…

The costs of healthcare in the US seem ridiculous to me, but the treatment given also seem better (given you can pay the exorbitant prices).

On a side note, over treatment seem a real threat.

Re: Amazon Health

#110

Post by dboreham »

mtgx wrote: post #76
dboreham wrote: post #57

Earlier quoted context omitted.

>The difference being that, in the US, the long-term dysfunction of our political system has allowed the regulatory framework for healthcare to be built to service its own industry, rather than the needs of individual citizens or society at large. You can templateize that statement, inserting pretty much any aspect of life in place of healthcare and it will still be true.

And that's because the US government no longer responds to the needs and wants of the people, but to the needs of corporations and rich people, which happened because of legalized bribery, or the ability to buy a politician's vote with "donation money". This is why Larry Lessig was right when he kept saying that this is the root cause that needs to be fixed before anything else . People should be supporting such "sin…

>And that's because the US government no longer responds to the needs and wants of the people

I'm an immigrant so I'm not clear it it ever did this: it hasn't in the 20+ years I've been here. Things I hear on the motivations of the founding fathers and the resulting deliberate dysfunctionality they introduced into the system of government suggests to me that the goal was never to respond to the needs and wants of the people.

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