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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
by 11thEarlOfMar 9y ago
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 motives). I paid $30,000 in health care expenses out of pocket that year for what was essentially a healthy family. I was not permitted to change insurance companies once I learned they had misled me.
Buffet calls them a tapeworm, I call it the next, ongoing rape of the American middle class.
- ensignavenger 9y agoYou should sue them for fraud.
- OnlyOnlyOnly 9y ago"I paid $30,000 in health care expenses out of pocket that year for what was essentially a healthy family." Outragous, I paid $10,000 in fire insurance for a house THAT WAS NOT BURNING!
- swarnie_ 9y agoHearing the report on Bloomberg news earlier today. Isn't this just for the 900k employees and isn't it just focusing on wearable tech? It sounded more like fitbit with cloud services than insurance.
- citizenkeen 9y agoKaiser Permanente was originally just for employees, so, you know, it could go somewhere.
- runako 9y ago> Isn't this just for the 900k employees and isn't it just focusing on wearable tech? I believe it's initially for the employees of those companies. If they can make it work for them, they have a great team (ecommerce, finance, insurance) to back a larger rollout. The announcement says it's about providing healthcare at lower cost with better results, which sounds like a lot more than wearables.
- joezydeco 9y agoStock market seems to confirm that theory. All the other healthcare stocks opened down this morning.
- FLUX-YOU 9y ago>It sounded more like fitbit with cloud services than insurance. If there are healthcare providers involved giving direct healthcare, there will need to be systems and development around medical records. That could easily be sold as a product to hospitals and providers outside of the AMZN/JPM/BRK company down the road. Taking a "beginner's mindset" to me sounds like they plan on writing their own stuff, except for interoperation like HL7, which is great because most of the stuff from EPIC/Allscripts/Cerner is drowning in technical debt.
- pbreit 9y ago"beginner's mindset" was my favorite line in the article. Classic Bezos. Yes, it might indicate building their own stuff. I also interpret it that sometimes the experts are too stuck in their ways.
- odonnellryan 9y agoI 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.
- prklmn 9y agoBuffet is the same guy that "fixed" other insurance markets by driving them away from mutual ownership to privately owned companies - a massive wealth transfer away from the common man. He shouldn't be commenting on tapeworms.
- tdees40 9y agoI'm genuinely fascinated by this comment. You're saying that mutuals offer lower prices (not typically true), but they were out-competed by private companies? I'm not sure that makes sense. In my sector (life insurance), there's no real pattern to mutual vs public company pricing, but maybe it's different in auto insurance, for instance.
- prklmn 9y agoIt goes beyond pricing. Mutual insurance policy owners were paid dividends based on principle investment. Berkshire pays dividends to shareholders, i.e. Warren Buffet, while policy holders get nothing but insurance coverage.
- jonknee 9y ago> Berkshire pays dividends to shareholders Berkshire has never paid a dime of dividends to anybody.
- hidenotslide 9y agoCapital gains are equivalent to dividends, just with better tax treatment. You are "technically" correct though, which is of course the best kind.
- weka 9y agoI 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 wife is high-risk and I have thyroid issues, our best bet was COBRA ($1,000 / mo) because the new startup I joined did not offer group health coverage. What followed next was this: - The HR person who was handling my COBRA papers left during all of this. Switched jobs. - Thanksgiving break - Weeks of "the system will update this weekend with your information." - "They were suppose to process your dental, but they never did" My wife and I tried using our new AETNA IDs once we had gotten them and they still told us that it did not work. I had to have an expensive thyroid blood test pushed back. Multiple dentist appointments postponed. Everything. FINALLY, once I got my SSN and ID for my coverage on AETNA, I had to pay back premiums all the way back to August 2017 just to keep using my coverage. So that's $4,000 USD for services I could not essentially render. $4000 of my hard-earned money. Gone. For nothing -- basically. They had the gall to tell me (AETNA did) "Sir, if you paid for anything out of pocket during the time of your retroactive coverage, we can pay you back any cost you incurred." The whole reason we get insurance is to avoid those high prices. I'm so spent. I'm not an angry man but these health insurance companies really drove it home for me. I feel taken advantaged of and it really stinks.
- rsync 9y ago"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 socialized, state sponsored medical care. There is no problem in looking for that and I make no value judgement here on that. The first step would be to stop mischaracterizing this as "insurance". It's not. It can't be. [1] Yes, certainly wellness checkups and things like them can be enormously economically beneficial for the provider since they spend up front preventative dollars instead of emergency, acute dollars later but it still doesn't change the fact that those are not underwriteable as they are regular, on-going expenses - very much like the tires on your car.
- austenallred 9y agoYou’re right, but respectfully, in the long term, “I want this specific provider at any cost” is somewhat of an edge case. A lot of (most?) people just want good healthcare and a low cost. That’s a complex but solveable problem.
- loco5niner 9y ago> “I want this specific provider at any cost” is somewhat of an edge case Not really. I want someone I can trust. For my primary care needs, I have established trust with someone and know their capabilities, their business practices, and their character. I don't want to roll the dice with someone new when I can still go to them. Example 1: My primary care provider(been seeing him for 10 years. Example 2: My dentist (been seeing him or his predecessor for 30 years)
- rocketpastsix 9y agoNo, its not an edge case. If you have a rapport with a doctor/care provider, you would want to stay with them. I have a genetic disease and an endocrinologist who helps me manage it. I wouldn't want to leave that doctor, who has seen me multiple times, has my charts, understands what Im working with, and so much more.
- nervousvarun 9y agoBut isn't that OP's point? By nature of your specific disease/condition you are a bit of an outlier no? Obviously the ideal would be you have a system that accommodates "my kid has a fever/fell out of a tree and broke their arm" majority of medical issues who could be helped by basically anyone trained in basic medicine while also accommodating people who need a rapport with a highly trained/expensive specialist. That's how I took the comment...apologies in advance if this comes off as insensitive to your condition, definitely not my intention.
- pc86 9y agoPeople want to believe that their medical condition(s) are a special, one-in-a-billion mix requiring years or decades of rapport-building and conversations. That's not the case for the vast majority of people, even with very complicated medical histories and diagnoses. "Has seen me in the past" and "has my charts" are not indicative of medical efficacy. There are doctors I have rapport with, absolutely. I still have lunch occasionally with the physician who was my family doctor as a child and still sees my parents. But that doesn't mean his medical treatment is going to be any better than a doctor seeing me for the second or third time.
- 23443463454 9y agoIt's a bit of an aside, but this whole issue, the bare knuckle fight about health care brings about an interesting deeper rooted issue that clearly and uniquely differentiates the two primary perspectives; one side always tends towards the heavy handed, imposing, authoritarian approach to force things they deem self-evident as desirable or have determined to be "good" and are thereby inherently inefficient and wasteful due to it's centrally planned, waterfall type approach ... and the other side tends to want to set up incentive structures that create pressures for efficiency and allows for free will and self-determination and discrimination to both succeed or fail on their own accord. It is an eternal struggle of authoritarianism and imposition trying to subdue self-determination and self-governance.
- citizenkeen 9y agoOr it's the eternal struggle of a community whole trying to overcome ruthless selfishness of those in power. Your naked partisanship is ugly and unhelpful.
- maxerickson 9y agoLet's tear down on the government restrictions on the sell side of the market before we champion the glory of the market. Repeal EMTALA. No patents. No certificates of need. Make Medicare and Medicaid fully opt in for providers. Create a path for additional private organizations to certify medical schools. Anyone refusing to do all that stuff and face the political consequences for it just wants to pay less taxes.
- 23443463454 9y agoI wasn't getting as specific as "championing the glory of the market". But in a general sense, what you are referring to the "market" is really the origin of control. Who is in control over your life and decisions in it and the consequences from it ... are you in control or some other party like politicians or bureaucrats who lord and decree and impose what you can choose if you have a choice at all, which invariably must include the ability to exclude oneself from matters that are not a common expense and value, which cannot be individually separated out like defense or cost of core governmental functions. It's the age old question, who is a better person to make decisions for yourself, you yourself, or some person somewhere that believes they know better what is best for you in your particular set of circumstances. Some call it communism, some marxism, some authoritarianism, some totalitarianism ... but ultimately they are simply differing degrees and characteristics of the same question ... who controls your life?
- dawhizkid 9y agoBut to be real here, the main motivation for creating this new venture is employer cost. Some people might not be aware that the vast majority of large employers in the U.S. that offer health insurance are self funded (i.e. they collect premiums from themselves/employees and take on all the insurance risk), so anything they can do to lower any direct/indirect cost with plan administration, claims, drug cost (big one), healthcare utilization, etc. will save them billions easily.
- yazaddaruvala 9y agoI’ve personally sent Jeff Bezos an email to take on more for-purpose capitalism. Something can be good for the bottom line and good for society. It’s not one or the other!
- greedo 9y agoDo you have anything to back this up? I work for an insurance provider, and this is not accurate in my experience.
- dawhizkid 9y agoback what up?
- astura 9y agohttp://www.benefitspro.com/2015/03/09/the-rise-of-self-funding http://www.benefitspro.com/2015/03/09/the-rise-of-self-fundi... >Only about 26 percent of employers with between 100 and 499 employees self-insure, compared with more than 82 percent of employers with 500 or more employees, according to data from the U.S. Department of Health and Human Services. That being said, they don't usually take on ALL the insurance risk, they typically purchase stop gap insurance for very large claims.
- rvo 9y agoI wonder if we could collectively use civil disobedience and refuse to pay for healthcare and insurance until major changes are made to the system. Non violent civil disobedience. Essentially a strike against the system.
- barneygumble742 9y agoYou could until someone gets sick and needs medical services, hoping they don't go bankrupt due to their lapsed coverage due to non-payment. The biggest problem I see are the costs. The healthcare industry can't even tell you why costs differ on so many levels of services. The industry isn't transparent and they'll fight this because it's too profitable for them.
- pbreit 9y agoWhat would you change?
- rayiner 9y agoYour desires are mutually incompatible. Imagine you’re contracting for cloud hosting services, and you start with the premise you’re not going to switch away from your existing provider. How do you achieve cost efficiencies in that situation?
- djrogers 9y agoSo basically the new company told you 'If you like your doctor, you can keep them!'?