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Discussion in 'Economy' started by dsl987, Jan 30, 2018.

  1. dsl987

    dsl987 Member

    I see Berkshire, JP Morgan and Amazon are teaming up to address healthcare.

    Amazon, Berkshire Hathaway and JPMorgan Team Up to Disrupt Health Care

    So it looks like some companies are sick of the healthcare system and are starting to do something about it. My company already has a doctor on site that can see you for routine stuff and now they have opened a separate clinic for family members. Its so refreshing to be able to go see a Doctor, not wait for an hour and only have to fork over $5

    Interesting that Healthcare stocks plunged today on the announcement.
  2. Allene

    Allene Registered User

    It will be very interesting to see how this works out!
  3. Biker

    Biker Administrator Staff Member

    I honestly don't see this making any type of huge impact in the long run. Unless they're going to stand up their own health network as part of the plan, the three companies don't have the financial clout to negotiate lower costs.
  4. dsl987

    dsl987 Member

    They'll probably start off by offering onsite medical care like my company does. It's a massive time saver being able to go downstairs versus going to a Doctor where you might literally waste a whole day. Not only does the company lose less time with employees being gone at the Doctor, but it saves them and the employee a lot of money.

    It will be interesting to see how this plays out.
    I was happy to see Trump say he would address high prescription drug prices last night, I just hope he can actually pull it off. Maybe they should just pass a law that says you can't sell in the US for higher prices than other countries. It's ridiculous that a prescription here can cost $500 but you can go across the border to Canada or Mexico and get the exact same thing for $50
    Last edited: Feb 1, 2018
    Allene likes this.
  5. Susan Addams

    Susan Addams Unregistered User

    I find it interesting to note that I have an investment position in both Amazon and Berkshire Hathaway, and bank with JP Morgan (Chase). Also please note that the health plan is for company employees, not the public at large.

    I once worked for a company with an on-site nurse and that was nice. I think for a company with a large workforce in a single location would benefit from having an on-site company doctor. This could amount to a decent savings in both company healthcare costs (if the onsite medical presence could be combined with off-site inpatient care, hospitals, etc.) and also increased profit due to increased productivity as a result of employees taking less time off for medical reasons. And how many healthcare problems would have lesser impact if medical care were to be delivered sooner?

    And why stop there? How about a company optician appearing on a weekly or other scheduled days?

    Oops. I just remembered I work at home, telecommute.

    As far as prescriptions, the situation has been ridiculous for ... all my life! Compare prescription drug prices in Canada to same in US. Even the same manufacturers! That shows you the power of collective negotiation. (I already get good drug prices. My pharmacy has my GoodRx.com discount on file and I don't even have to print coupons any more. GoodRx is a free service and all I can say is that whenever you see a free product, the product is you! I don't know how they are financially structured but my drug prices are so cheap I get by just fine with no drug coverage.)

    By the way, perhaps not closely related, but... Just for fun some time compare the cost of some prescription drug, say X drug, #90 for 3 month refill, taken once a day: 1 mg, 2 mg and 5 mg. I've done that myself and found that the prices for different dosages are almost identical (e.g. #90 1 mg almost same price as #90 2 mg or 5 mg). That's why smart patients and/or smart doctors who care about patient healthcare costs prescribe double the dose and tell the patient to get a pill splitter and take half the doubled dose daily. Right there you can cut your drug costs by almost half.

    It is obvious that the cost of actually manufacturing a prescription drug is a small part of the end item cost.
    Last edited: Feb 11, 2018
    Allene likes this.
  6. Arc

    Arc Full Member

    Healthcare in the urban US is only high quality if:

    1. You are rich or have kickass insurance.

    2. You take personal responsibility to understand your health and to treat it accordingly.

    Otherwise, healthcare in the US is mediocre to very poor.

    As for Amazon et al. group experimenting with it, like biker I feel it is more likely than not that nothing substantial will come of it.
    Allene likes this.
  7. Susan Addams

    Susan Addams Unregistered User

    Well it's for their employees only. Think of it as an expanded concierge system. It's not going to benefit the rest of us at all except indirectly stockholders.
  8. dsl987

    dsl987 Member

    It might not affect us directly but I think it's a sign of the changing times. People are sick of the mess that is healthcare and are starting to do something about it
  9. Susan Addams

    Susan Addams Unregistered User

    People aren't doing anything about it. Amazon, Berkshire and Chase aren't people.

    The government isn't doing anything about it either. They are trying to regulate healthcare costs by regulating the healthcare INSURANCE industry. They have the WRONG industry!

    They aren't trying to regulate healthcare at all. Pure and simple, the only thing government has done is attempt to eradicate the healthcare insurance industry and turn the system into a single payer system.

    What use is there to have healthcare insurers at all if it's a single payer system? And once we have that, guess what? The true source of the expenses, the medical industry, won't have changed a bit.

    You have the right race but you have the wrong horse.
  10. ShinyTop

    ShinyTop I know what is right or wrong!

    Susan, I posted the following shortly after ACA passed.

    The saddest part of the health bill just passed is not that it will cost Caterpiller so much money it will affect jobs creation. It is not that any one segment will have more or less taxes or that any part of the population will have better or worse health care.

    It is that this sad excuse for a health care bill will become entrenched.

    Oh, we had to start somewhere is an argument we hear. It is better than nothing is an argument we hear. Both are sad excuses for not having been able to do better. Both will be long forgotten down the road when someone lists the steps taken to the ruination of American health care.

    The first step taken should have been fixing the items wrong with the current system. Or at least they should have been the foundation of this bill. Instead the administration decided they wanted their legacy to include a national health care bill. I suspect the passage of this bandaid-do little approach will be listed as the biggest, most long lasting failure of the administration.

    Where is the protection for medical practitioners from frivolous lawsuits?

    Where is the fix for medical payments for Medicaid, Medicare, and Tricare? Either the government is putting the screws to doctors for treating patients under these programs or medical care is so overpriced for everybody else that doctors don’t want to waste their time with these patients. Either way it has to be fixed for any system to succeed.

    Where are the laws with meat to severely punish doctors who scam the system? Where is the push for the feds and state governments to quit allowing insurance companies to disappear when they are facing actually honoring their policies?

    Where are the reforms for the cost of prescription medicine?

    Where is the specific program to provide medical care in a cheaper manner than sniffles and splinters in the emergency rooms?

    We needed preexisting conditions covered. But how can you hope to make that affordable for the country unless everybody is paying for some coverage all along. The bogeyman of people getting insurance the day after they discover their expensive disease sounds pretty certain. So if we need a single payer, must have coverage system how did we arrive at a system that keeps so much the same?

    So what politician did you hear speaking up for a system that protects all Americans. Each of them did their job of protecting their constituents (funny how that also keeps their asses in their fat cat seats) but I did not or hear of anybody standing up and demanding a system that will protect the most people for the longest time.

    So we are letting/demanding that our federal government take over every function of our lives. At the same time no local government can afford to come up with a solution based on what their part of the country wants.

    So we have a health care bill and BO has something he thinks he can hang his legacy on. And future attempts to make our system work better will be based on this bill. A bill stacked on top of such a weak foundation it cannot hope to improve health care in the long run. Maybe the strategy all along was to pass such a bad bill that the whole system will collapse so it can be built right. All I am sure of is that a bad bill is not better than no bill at all. And that as long as we accept bad legislation in lieu of actually fixing national issues the less hope we have of actually improving anything
  11. Susan Addams

    Susan Addams Unregistered User

    I still say that we are addressing the wrong sector with all our attempts to accomplish progress. This is all aimed at the middleman: insurance companies. Instead, we should address the healthcare providers themselves, doctors and hospitals.

    As far as the insurance companies are concerned, the solution is simple. Get rid of the stupid state-by-state structure and allow insurance companies to compete across state lines. Take states completely out of the equation of regulating healthcare insurance companies and regulation should be governed by the federal government. Right away you will see the holding companies and their various single state companies merge and become nationwide insurers, and with their monopolies gone they'll have to compete head to head against one another. That right there will solve the healthcare insurance cost problem.

    As far as fixing the doctors and hospitals, that's a subject for another day. But again, get the states out of the equation and have all doctors and hospitals comply with a single set of federal regulations.

    We don't want the government to take over and run things. Just let Congress legislate the regulations and hand it to the court system. The government should have no day-to-day role in this except to deliver funding such as Medicare etc. to the recipients who qualify. For people or employees it's up to them or their employer to shop for the best coverage provided on a level playing field of nation wide healthcare insurers, or self-insure if they wish.
  12. Biker

    Biker Administrator Staff Member

    No, it won't. Much of the cost wrapped into those insurance prices are the cost of lawsuits, malpractice, etc.

    Again, wrong end of the stick.

    To really get to the root of the issue, we need tort reform first. THEN you can work on the insurance and actual healthcare costs. But until those outrageous settlement claims are dealt with via tort reform, nothing you can do will fix things anywhere else in the chain.
  13. Susan Addams

    Susan Addams Unregistered User

    I'll go for tort reform. One thing I don't understand is why we haven't had any action on allowing healthcare insurers to operate across state lines. That right there would save consumers a lot of money.

    Hate to go off topic but there is a simple solution for the illegal alien problem too. We already have a system where any employer can check a prospective employee's legal right to work in the US. All the feds have to do is crack down heavily on employers who knowingly hire illegals and didn't check the registry. Many of the illegals would go home if they couldn't find work. We don't need the wall to stop illegal immigration... We need the wall to stop drug trafficking.

    It's frustrating that there are so many easy solutions to many national problems, yet nobody is doing anything about doing them. Then you got the sanctuary states? That just astonishes me that cities and entire states are choosing to simply ignore federal law. Our country is dysfunctional.
  14. MemphisMark

    MemphisMark Old School Conservative

    I said this on my blog (still down, however getting ready to come back!) a while back.

    Basically, insurance providers go nationwide and post what they will pay for a procedure, by ICD-10 code. Healthcare providers post their prices, again by ICD-10 code. Think like a McDonald's menu board.

    You choose the provider, use the service, pay for the service (get a bill if you can't pay for it all up front), getting a bill by ICD-10 code. You send the bill to the insurance company, they reimburse you.

    This allows you to doctor shop according to your criteria of price vs. service, you know what you're paying, then you get your monies back from the insurance. If you get $100 for a procedure, and Dr. A charges $90 and Dr. B charges $110 for that code, you can go with the cheaper Dr. and pocket the difference, or pay that $10 because you think it's worth it.

    I promise you, premiums and healthcare costs will both plummet because of the introduction of market forces. Insurance and HC providers overhead will drop by eliminating claims processing admin positions (some HC providers have a person dedicated to filing and tracking claims to one insurance provider), no contracts between HC providers and insurance companies. If a doctor is charging more than other HC providers, there better be a higher quality/more services assigned to those higher costs to justify the prices or everyone will go to the less expensive doctors.

    This will also eliminate "out of network" bullshit.
  15. Arc

    Arc Full Member

    When will the general public figure out that the number one reason by a country mile for the high cost of medical care is the evolution of the entities we call Medical Insurance Companies?
    ethics likes this.
  16. MemphisMark

    MemphisMark Old School Conservative

    Actually, it's more Medicare/Medicaid. For a given procedure, for every dollar paid by private insurance companies, Medicare/Medicaid pays 80 cents. So, HC providers raise their rates to the point where they make a prodit on the Medicaid/Medicare patients, then make more off insurance companies.

    The ACA also has that "community rating," which means that the price to elderly customers of the insurance companies are capped at 3x the price to 20-30 year-old customers, when you look at the medical costs, they cost 8-10x more.

    How do the ACA insurance companies make up for this? The raise the rates on the young people until the 3x becomes break even on the elderly.

    Hospitals also have at least three price structures, "Charge for all the market can bear," "Insurance company" and "Government." When I almost died in 2014, the "Charge for all the market can bear" price for my stay was $127,000. The "insurance discount" dropped that to $25,000. In the end, like all private businesses, hospitals have to make a profit or they close.
  17. Susan Addams

    Susan Addams Unregistered User

    That's my opinion too. Predatory healthcare insurance companies. They call the shots on all the regulations through their lobby. HC insurance companies are why we have an artificial wall that prohibits HC insurance being sold across state lines. If nothing else we should get rid of that law right now, and allow consumers to purchase their healthcare insurance from any insurer in the nation. That is what we call competition. Competition among providers causes reduced prices for consumers. That is why healthcare insurance companies don't want consumers to be able to buy their insurance just anywhere. They're virtually monopolies.

    This is one of the most annoying features of our healthcare system. It applies to doctors, hospitals and pharmacies. It's just not right to charge different people different prices. There should be just one price for everybody.
    Allene likes this.
  18. dsl987

    dsl987 Member

    "Hospitals have to make a profit or they will close"....except that's not necessarily the truth.

    Hospitals are now exploiting non-profit status to pad their earnings even more. Kind of like those scam charities where only 5% goes to charitable causes, with the rest being eaten up by "expenses"

    "No we cannot possibly be gouging you - we're a non profit"
    Last edited: Feb 17, 2018
    ethics, Arc and Allene like this.
  19. MemphisMark

    MemphisMark Old School Conservative

    Non-profit == no net profit. Net profit is paid to the owner/investors/shareholders (I've worked for several non-profits). "Net profits" for a non-profit are supposed to be poured back into the organization to expand it or drop prices. Or increase executive benefits.

    Every business has to have a sustained condition of income >= expenses to exist for the long term. It doesn't matter the nature of the revenue streams. They can be charging for their services, fundraising, accepting donations, grants/subsidies or anything else. No business can withstand an extended period of income < expenses.
  20. Arc

    Arc Full Member

    Wonder why we haven't seen an "HRC Healthcare Network Provider" chain yet?

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