Competition for medical-insurance companies?

[lpetrich]

Amazon, Berkshire Hathaway And JPMorgan Chase Launch New Health Care Company : The Two-Way : NPR

Health care costs are "a hungry tapeworm on the American economy," Berkshire Hathaway Chairman and CEO Warren Buffett says, and now his firm is teaming up with Amazon and JPMorgan Chase to create a new company with the goal of providing high-quality health care for their U.S. employees at a lower cost.

The new company will be "free from profit-making incentives and constraints" as it tries to find ways to cut costs and boost satisfaction with the health care plan for employees of Amazon, Berkshire Hathaway and JPMorgan Chase. The trio unveiled their new venture in a news release.

All well and good, and I think that the medical-insurance companies deserve it, but it does not address the problems that have resulted from tying health-care coverage to employment.

 

[SimpleDon]

Amazon, Berkshire Hathaway And JPMorgan Chase Launch New Health Care Company : The Two-Way : NPR

Health care costs are "a hungry tapeworm on the American economy," Berkshire Hathaway Chairman and CEO Warren Buffett says, and now his firm is teaming up with Amazon and JPMorgan Chase to create a new company with the goal of providing high-quality health care for their U.S. employees at a lower cost.

The new company will be "free from profit-making incentives and constraints" as it tries to find ways to cut costs and boost satisfaction with the health care plan for employees of Amazon, Berkshire Hathaway and JPMorgan Chase. The trio unveiled their new venture in a news release.

All well and good, and I think that the medical-insurance companies deserve it, but it does not address the problems that have resulted from tying health-care coverage to employment.

You have to take small steps. There are probably two paths to a reasonable cost health care system. Neither involve private, for profit health care insurance companies or for profit hospitals. They caused the problem of high cost medical care. They can't be part of the solution.

One path is by the government, Medicare for all. It would be reasonable to lower the eligibility age first to 50 years old. Charge over fifty year olds say $600 a month until they reach 65, paid for most by the employer, as a relief from what it is now, about $1200 to $1400 a month. Increase the payroll tax by 1% to 2% and make the rest of the cost out of the general fund, to cover the unemployed and the poor, just like the economy needs highways and harbors, the economy needs healthy workers. This would lower the medical premiums for the under 50 year old to about $600 a month too.

The other path is to encourage doctor run, not for profit healthcare companies to cover primary and all but the hospitalization for the most serious diseases and conditions, for which the companies would buy insurance graduated by their financial strength and use. Yes, the much maligned health maintenance organizations. This is what these companies are doing.

The government currently pays for about 50% of the medical care in the US, with very little crying about socialism because they cover the people that the private, for profit insurance companies can't cover profitably and who they don't want to cover. They want to cover healthy people in a very high medical cost market. This is why they working with the hospital corporations have encouraged the dramatic cost increases we have seen since the 1970's.

 

[Trausti]

Insurance coverage is only part of the issue. The principal problem with healthcare in the US is cost. There is little rhyme or reason to them. It might be helpful if medical providers were required to give patients quotes before care is rendered. Then patients could shop around and costs should come down. See Lasik.

 

[SimpleDon]

Insurance coverage is only part of the issue. The principal problem with healthcare in the US is cost. There is little rhyme or reason to them. It might be helpful if medical providers were required to give patients quotes before care is rendered. Then patients could shop around and costs should come down. See Lasik.

Of course, the problem that we are having is with the costs. We are talking about ways to lower the costs. Competition can only have a limited impact on the costs. Lasik is an outlier in healthcare, a example of what specialization and assembly line surgery coupled with high volume and innovation can do rather than competition among equals, what we would need to significantly lower overall healthcare costs.

Another like example is the many imaging clinics that have lowered the costs of x-rays, CAT scans and magnetic resonance imaging, ironically increasing the costs of the same in hospitals because the competition has decreased the business that hospital do, increasing the capital cost per image form the machines that the hospitals feel they have to have. The overall costs of medical care has gone up because of the innovation and competition of the dedicated imaging centers.

What has made insurance coverage important is that the insurance companies realized that they all would make more money if the medical costs increased. What made the hospital owning companies important is that they realized that they could all make more money if medical costs went up. What is incompatible with healthcare is the profit motive and the resistance big business has to competing on price with each other.

And no, more regulation isn't going to increase the competition among the insurance companies or the hospital corporations. Less regulation isn't going to increase competition among the for profit companies either, this is a fantasy believing that these large companies that are making so much money by colluding together, in the current term of art, would change if set free of the regulations that we have.

The US had comparable medical costs to the rest of the developed world when it had a community rate based non-profit insurance company, Blue Cross-Blue Shield that could dictate rates at non-profit hospitals owned by local governments and charities. What drove up costs so high was when the insurance companies and the hospital companies became for profits. It is profits that are incompatible with healthcare.

Healthcare must be delivered by doctors working with their training and their professionalism.

 

[Loren Pechtel]

The US had comparable medical costs to the rest of the developed world when it had a community rate based non-profit insurance company, Blue Cross-Blue Shield that could dictate rates at non-profit hospitals owned by local governments and charities. What drove up costs so high was when the insurance companies and the hospital companies became for profits. It is profits that are incompatible with healthcare.

Healthcare must be delivered by doctors working with their training and their professionalism.

By far the biggest driver of health care cost is that we can do more than we used to be able to.

 

[dismal]

wrong thread

 

[SimpleDon]

The US had comparable medical costs to the rest of the developed world when it had a community rate based non-profit insurance company, Blue Cross-Blue Shield that could dictate rates at non-profit hospitals owned by local governments and charities. What drove up costs so high was when the insurance companies and the hospital companies became for profits. It is profits that are incompatible with healthcare.

Healthcare must be delivered by doctors working with their training and their professionalism.

By far the biggest driver of health care cost is that we can do more than we used to be able to.

If that were the case medical care costs would have soared in the rest of the developed world just like it did in the US. Do you think that the entire rest of the developed world now does less for their patients to make our products not competitive because of our high medical costs?


I am sorry, I have taken over the thread, answering questions not directed to me. I have been told this is considered impolite here.

 

[Loren Pechtel]

The US had comparable medical costs to the rest of the developed world when it had a community rate based non-profit insurance company, Blue Cross-Blue Shield that could dictate rates at non-profit hospitals owned by local governments and charities. What drove up costs so high was when the insurance companies and the hospital companies became for profits. It is profits that are incompatible with healthcare.

Healthcare must be delivered by doctors working with their training and their professionalism.

By far the biggest driver of health care cost is that we can do more than we used to be able to.

If that were the case medical care costs would have soared in the rest of the developed world just like it did in the US. Do you think that the entire rest of the developed world now does less for their patients to make our products not competitive because of our high medical costs?


I am sorry, I have taken over the thread, answering questions not directed to me. I have been told this is considered impolite here.

Rationing. People like to pretend it doesn't happen in UHC countries but it does. It's just subtly built into the system.

Despite our very poor performance at covering people our medical outcomes are at the front of the pack if not #1--and the only way that can happen is if the care that people actually get is far beyond to make up for the ones that don't get care in the first place.

 

[humbleman]

Two cases called me the attention. An old man with need of knee repairs by replacing a bone with a metal one, and another a young person with destroyed liver by alcohol consumption. In both cases, they have the least insurance cover but signed for monthly payments "per life".

The one with need of a new liver almost lost his life because no available livers fit his blood type. At last minute one liver was available for him and he can live some years more.

But, their cover was the minimum and the companies knew that they won't recover much from these two patients.

How it come that I read here that companies look for profit alone, when in these two cases the patients even living many years won't be able to pay what they owe?

One thing is right, the prices for surgery in both cases were very expensive, but weren't denied to the patients.

I don't know about patients with cancer or other diseases.

In any case, to me the health care was working the same before the Obamacare era, and will continue the same after Obamacare is dismantled.

Insurance companies find the way to survive, they compete between themselves and not so against the patient.

There are also many community services, like the Catholic Church which in Washington DC provided doctor consultations at $20.00 per visit and sometimes patients received free medicines.

No income asked, no religion preference was reason for not receiving care, professional doctors, and actually some of them coming from other countries and working as assistants until their papers were recognized in the US.

The State governments have programs to help low income people with a percent of the premium, sometimes more than two hundred dollars depending of the selected program.

The health system, even if not perfect and covering all Americans, it does work. Prices are higher, yes, some insurance companies deliver patients to doctors with poor standards, yes, regardless of some inconvenience here and there, it does work.

What is expected to the future? Perhaps higher premiums, in my case, I don't care anymore: my electric bill is higher, the gas bill is up, the water bill touching the ceiling, the house taxes incremented, how I'm going to care anymore when my vodka bottle cost $1.50 more and packs of cigarettes make my wallet losing weight and size? Even McDonald meals cost like Chipotle dinners, sodas can't be found at 99 cents anymore, now they cost $1.99. Fried chicken also cost $1.50 a piece from 99 cents a few months ago, and the food market... mamma mia!!! grapes 3.25 per lb. when recently were $2.29 per lib., I don't even look at the tomatoes, I turn my face away the fruit and vegetable areas, farmer fish more expensive than Sirloin steak, I think next time they will charge me $3.00 entrance to the store

In over the counter medicines, forget about it: you can't have stomach ache because the good diet described right above, and you'll find out that anti-acid bottle of pills costs as much as a large popcorn and large soda at the movie theater... no, definitively this is too much.

I don't care anymore about raising cost of premiums in my health care insurance. I don't know what I was trying to say here after all... but thinking in those prices made lost me... I mean... my... my... see? I can't even... aaaghh... i better just click the Post Quick Reply box... hell with this bored topic!

 

[untermensche]

They are doing what the government should be doing.

They are doing what the government could do if it were not polluted by the disproportionate power of concentrated wealth within it.

Do away with these huge corporations and we won't need them to clean up the messes from other huge corporations, like the for-profit "health" insurance corporations ultimately looking out for their own health.

 

[LordKiran]

If that were the case medical care costs would have soared in the rest of the developed world just like it did in the US. Do you think that the entire rest of the developed world now does less for their patients to make our products not competitive because of our high medical costs?


I am sorry, I have taken over the thread, answering questions not directed to me. I have been told this is considered impolite here.

Rationing. People like to pretend it doesn't happen in UHC countries but it does. It's just subtly built into the system.

Despite our very poor performance at covering people our medical outcomes are at the front of the pack if not #1--and the only way that can happen is if the care that people actually get is far beyond to make up for the ones that don't get care in the first place.

Rationing of healthcare happens everywhere. We ration healthcare according to wealth and access.

 

[Alcoholic Actuary]

Amazon, Berkshire Hathaway And JPMorgan Chase Launch New Health Care Company : The Two-Way : NPR

Health care costs are "a hungry tapeworm on the American economy," Berkshire Hathaway Chairman and CEO Warren Buffett says, and now his firm is teaming up with Amazon and JPMorgan Chase to create a new company with the goal of providing high-quality health care for their U.S. employees at a lower cost.

The new company will be "free from profit-making incentives and constraints" as it tries to find ways to cut costs and boost satisfaction with the health care plan for employees of Amazon, Berkshire Hathaway and JPMorgan Chase. The trio unveiled their new venture in a news release.

All well and good, and I think that the medical-insurance companies deserve it, but it does not address the problems that have resulted from tying health-care coverage to employment.

This sounds like more than just insurance company competition. Although the details are fuzzy, it appears as though they are targeting costs all up and down the health-care supply chain. What if they hired their own medical staff at their largest locations? What if Amazon applies it's delivery system to medical supplies and prescription drugs (which they have already intimated they might do)?

There are a lot of ways a motivated employer could improve care and slash costs to their employees' health system.

aa

 

[Jimmy Higgins]

Depending on your location, competition for health insurance might not be the problem, but rather the general cost of everything. We all need the medical system, so we all need to be paying into it up front. It is not equitable for someone to have to shell out hundreds or thousands of dollars because they were born with a floppy mitral valve or a gall bladder rotted on them or they got cancer. This luck of the draw American US Health Care pay set up is crap.

If that were the case medical care costs would have soared in the rest of the developed world just like it did in the US. Do you think that the entire rest of the developed world now does less for their patients to make our products not competitive because of our high medical costs?


I am sorry, I have taken over the thread, answering questions not directed to me. I have been told this is considered impolite here.

Rationing. People like to pretend it doesn't happen in UHC countries but it does. It's just subtly built into the system.

Despite our very poor performance at covering people our medical outcomes are at the front of the pack if not #1--and the only way that can happen is if the care that people actually get is far beyond to make up for the ones that don't get care in the first place.

Odd, almost all Americans ration their health care. How many people didn't see a doctor because of the fear of the cost?

Insurance coverage is only part of the issue. The principal problem with healthcare in the US is cost. There is little rhyme or reason to them. It might be helpful if medical providers were required to give patients quotes before care is rendered. Then patients could shop around and costs should come down. See Lasik.

Of course, then you need to track the cost of say an MRI via different insurance groups too. So Hospital A MRI via Anthem, Ohio Medical, etc... then Hospital B MRI via the same insurance companies. It is impossible to find out how much anything costs because there are too many levels!

 

[James Brown]

Who wants to shop around for medical care when you're in the back of an ambulance with head trauma because of a car accident?

 

[SimpleDon]

If that were the case medical care costs would have soared in the rest of the developed world just like it did in the US. Do you think that the entire rest of the developed world now does less for their patients to make our products not competitive because of our high medical costs?


I am sorry, I have taken over the thread, answering questions not directed to me. I have been told this is considered impolite here.

Rationing. People like to pretend it doesn't happen in UHC countries but it does. It's just subtly built into the system.

Despite our very poor performance at covering people our medical outcomes are at the front of the pack if not #1--and the only way that can happen is if the care that people actually get is far beyond to make up for the ones that don't get care in the first place.

And the rationing is so subtle that it relieves you of having to support your statement with anything resembling objective information, what was called in more innocent times "facts" without adjectives like "fake" and "alternative".

The other developed countries had UHC's in 1970. Were these UHC's that didn't ration healthcare? If so what made them ration health care while the US was slowly converting its healthcare into a for profit industry?

If they did subtly ration health care in 1970 what changed to today that they now provide health care at a much lower cost than the US?

Excuse me for saying but it would appear that you base these comments on how you feel that things should be rather than how things are. Take your second point that in spite of the tens of millions that do not have regular health care in the US it is still #1 or close to it because of the far superior care that the fortunate ones who can afford it drive up the average. I searched on Google for "Health outcomes in the US compared to rest of the world" which produced the following, in order, the first flve, no cherry picking,

The U.S. spends more on healthcare than any other country — but not with better health outcomes -- The LA Times.

espite repeated attempts by Senate Republicans to dismantle the Affordable Care Act, the healthcare debate in Washington appears to have collapsed — for now.

The United States has much room for improvement when it comes to healthcare, experts said. “The U.S. spends more on healthcare, but we don’t have the same health outcomes [as other countries],” said Cynthia Cox, associate director at Kaiser Family Foundation, a nonprofit organization that researches national health issues.

Americans have also long voiced their disillusionment with a system that many experts have warned does not meet the health needs of its population.

But while lawmakers engaged in heated back-and-forth debates in recent months over how to reform the U.S. healthcare system — ending in a lack of sufficient votes on Monday to make changes — people in many other countries have managed to get it right for years and enjoy a stable healthcare system.

Viewed from a global perspective, the current U.S. healthcare impasse underscores just how poor health outcomes for people in the United States are when compared with other countries.

How does the quality of the U.S. healthcare system compare to other countries? -- Kaiser Family Foundation. This is the report quoted in the LA times article above.

This collection of charts and a related brief explore a number of different metrics used to look at health outcomes, quality of care, and access to services. Inconsistent or unavailable data and imperfect metrics make it difficult to firmly judge system-wide health quality in the U.S., but a review of the data we do have suggests that the system is improving across each of these dimensions, though it continues to lag behind comparably wealthy and sizable countries in many respects.

U.S. Health Care from a Global Perspective -- The Commonwealth Fund.

This analysis draws upon data from the Organization for Economic Cooperation and Development and other cross-national analyses to compare health care spending, supply, utilization, prices, and health outcomes across 13 high-income countries: Australia, Canada, Denmark, France, Germany, Japan, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. These data predate the major insurance provisions of the Affordable Care Act. In 2013, the U.S. spent far more on health care than these other countries. Higher spending appeared to be largely driven by greater use of medical technology and higher health care prices, rather than more frequent doctor visits or hospital admissions. In contrast, U.S. spending on social services made up a relatively small share of the economy relative to other countries. Despite spending more on health care, Americans had poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions.

"Maybe We Could Have Bought Him a Good Pair of Shoes": Why Peer Nations Spend Less on Health Care but Stay Healthier

United States Comes in Last Again on Health, Compared to Other Countries -- NBC news report of The Commonwealth Fund report above.

Americans are still struggling with their health, and rank last against citizens of 10 other wealthy countries when it comes to emotional distress, struggling to pay for care and skipping doctor visits, a new report finds.

The latest report from the Commonwealth Fund, which routinely points to the shortcomings of the U.S. healthcare system, shows not much has changed in 15 years or longer. Americans still pay far more for medical care than people in other rich Western nations but have little to show for all that spending.

U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries -- Forbes. A column on a previous Commonwealth Fund report.

Earlier this year, Cadillac ran a controversial TV ad that first aired during the opening ceremonies of the 2014 Winter Olympics. It was called "Poolside" and featured actor Neal McDonough extolling America's work ethic over other countries — specifically France.

Turns out that many of those "other countries" (including France) score better than the U.S. in one key metric not included in Cadillac's TV spot — healthcare. At least that's according to The Commonwealth Fund in their latest report "Mirror, Mirror On The Wall — 2014 Update" (pdf here).

For this year's survey on overall health care, The Commonwealth Fund ranked the U.S. dead last .

Since there was really only two sources in the above articles I will give you one more from other sources, but without the quotes to conserve some space.

Infographic: How Does U.S. Health Care Stack Up to the Developed World? Spoiler alert: Not well. -- Foreign Policy.com. A short article on a report from the Peter Peterson Foundation.

How do you explain these?

They seem to dispute your feelings.

 

[Loren Pechtel]

If that were the case medical care costs would have soared in the rest of the developed world just like it did in the US. Do you think that the entire rest of the developed world now does less for their patients to make our products not competitive because of our high medical costs?


I am sorry, I have taken over the thread, answering questions not directed to me. I have been told this is considered impolite here.

Rationing. People like to pretend it doesn't happen in UHC countries but it does. It's just subtly built into the system.

Despite our very poor performance at covering people our medical outcomes are at the front of the pack if not #1--and the only way that can happen is if the care that people actually get is far beyond to make up for the ones that don't get care in the first place.

Rationing of healthcare happens everywhere. We ration healthcare according to wealth and access.

Agreed--my point was that rationing also happens under UHC systems, and in terms of total care denied it's greater than it is under ours.

 

[Loren Pechtel]

Infographic: How Does U.S. Health Care Stack Up to the Developed World? Spoiler alert: Not well. -- Foreign Policy.com. A short article on a report from the Peter Peterson Foundation.

How do you explain these?

They seem to dispute your feelings.

Wikipedia:

Total health expenditure per capita in U.S. dollars. Not inflation adjusted.

2015 (the last year they have data for):

#1: Switzerland $9,818
#2: USA $9,536

 

[Playball40]

If that were the case medical care costs would have soared in the rest of the developed world just like it did in the US. Do you think that the entire rest of the developed world now does less for their patients to make our products not competitive because of our high medical costs?


I am sorry, I have taken over the thread, answering questions not directed to me. I have been told this is considered impolite here.

Rationing. People like to pretend it doesn't happen in UHC countries but it does. It's just subtly built into the system.

Despite our very poor performance at covering people our medical outcomes are at the front of the pack if not #1--and the only way that can happen is if the care that people actually get is far beyond to make up for the ones that don't get care in the first place.

bullshit. prove it

 

[Jimmy Higgins]

Who wants to shop around for medical care when you're in the back of an ambulance with head trauma because of a car accident?

Or low ball your cancer treatment costs.

 

[RavenSky]

Insurance coverage is only part of the issue. The principal problem with healthcare in the US is cost. There is little rhyme or reason to them. It might be helpful if medical providers were required to give patients quotes before care is rendered. Then patients could shop around and costs should come down. See Lasik.

Sure.

My daughter, unconscious and her body broken after having her car hit by an 18-wheeler, was perfectly capable of shopping around for an emergency plastic surgeon who would be more competent and charge less than the son-of-bitch who treated her that night.