I love that Amazon is moving in this direction. Employer-provided health insurance is a total racket. I would love to see Medicare-for-all in the US, and suppo

I love that Amazon is moving in this direction. Employer-provided health insurance is a total racket. I would love to see Medicare-for-all in the US, and support that. But we also need a plan B. But how do you break a racket? You can’t just built a startup, because the market is fucked: everyone with money already gets care for free. Most of the people who need care are broke. And there are so many layers of indirection: patient -> employer -> insurer -> provider.... that you’re not just dealing with a single racket, you have layers of protectorates that are milking people at every stage. Plus there’s the scale issue, with a pool of 100 patient-customers, a few bad years can sink your startup. Yes you can buy specialty insurance, but it would need to be a very complex product and you need scale to make that appealing to an underwriter. Which brings me to why I am excited about Amazon trying this: A big employer seems like the only party other than the state who can break the racket. Amazon is more or less bearing the full cost of their employees care, and they have the scale to act as their own insurer. They also have the software and data science teeth needed to build the backoffice. Medicare for all is what we need, but I support Amazon because I believe in the diversity of tactics.