Tuesday, 30 January 2018

Amazon, Berkshire Hathaway and JP Morgan Chase to create independent healthcare co. for employees

quote [ Three major employers, Amazon, Berkshire Hathaway and JP Morgan Chase, announced Tuesday they were partnering to create an independent company aimed at reining in health care costs for their employees. ]

This is a follow up to my previous post about a not-for-profit generic drug company forming to fight rising health costs. Makes sense that the business giants would take the whole healthcare tar-baby in house at some point. Text in extended because WaPo.

Previous post on generic drugs:
http://www.sensibleendowment.com/entry.php/11111

Article from Bloomberg:
https://www.bloomberg.com/news/articles/2018-01-30/amazon-berkshire-jpmorgan-to-set-up-a-health-company-for-staff

WaPo article is short at this point, still under the "Breaking News" headline.
Reveal


Amazon, Berkshire Hathaway and JP Morgan Chase join forces to tackle employees’ health care costs

By Carolyn Y. Johnson January 30 at 8:31 AM, Washington Post

Three major employers, Amazon, Berkshire Hathaway and JP Morgan Chase, announced Tuesday they were partnering to create an independent company aimed at reining in health care costs for their employees.

The independent company would be jointly led by executives from all three companies and would be focused on technology that could increase transparency and simplify health care, according to the joint announcement. It will be free from the need to deliver a profit.

"The ballooning costs of healthcare act as a hungry tapeworm on the American economy. Our group does not come to this problem with answers. But we also do not accept it as inevitable," Warren Buffett, Berkshire Hathaway chairman said in a statement.

Few details were available about the new initiative, which is described as in the initial planning stages. The announcement comes amid anticipation that Amazon could disrupt health care as it has in other industries -- sending tremors through companies that make and supply prescription drugs.

“The healthcare system is complex, and we enter into this challenge open-eyed about the degree of difficulty,” Jeff Bezos, Amazon founder said in a statement. “Hard as it might be, reducing healthcare’s burden on the economy while improving outcomes for employees and their families would be worth the effort. Success is going to require talented experts, a beginner’s mind, and a long-term orientation.”
[SFW] [health] [+7 Informative]
[by midden@1:53pmGMT]

Comments

steele said @ 2:42pm GMT on 30th Jan [Score:1 Insightful]
So basically they're trying to undermine the medicare for all movement. "See? No need to get the government involved. Private healthcare can be done right." #ForNow
bbqkink said[1] @ 7:54pm GMT on 30th Jan [Score:1 Underrated]
I think they got tired of waiting on the government to do it. The only reason you need an insurance company at all is they provide the loan of money. These companies don't need to borrow money and neither does the government. At an approximate cost of 20% insurance companies pay hospital and doctor bills...an outrageous loan rate especially when most of that money is guaranteed by the government o start with.

This may raise insurance rates for everybody else...greatly. taking this many mostly healthy people out of the pool is not good for the insurance companies bottom line. But it will show that nonprofit health care works.

And I also heard that they may offer it to other companies after they get it off the ground.
LurkerAtTheGate said @ 8:53pm GMT on 30th Jan [Score:4 Underrated]
I read an article a while ago with history on nationalized healthcare systems, which stated in many cases (most notably UK & Germany) the political push for nationalized healthcare was lead by the Conservative party - removing burden of paying for insurance/care from the employers, generally seen as a business-friendly move.

A friend of mine is of the opinion that the reason this hasn't taken off in the US the same way is that employers see it as in-their-interest to keep employees beholden to their employer for healthcare.
bbqkink said[1] @ 11:15pm GMT on 30th Jan
That makes sense. That was one of the things that happened with the ACA there was a lot of turnover just after it was passed. Insurance was the reason these people kept jobs they hated.
midden said @ 11:06pm GMT on 30th Jan [Score:1 Underrated]
That's exactly my disagreement with steele. As a business, they don't want to muck about with medical insurance, but it has become such a drag on their profits that they are compelled to do something about it.
steele said @ 11:57pm GMT on 30th Jan
To me, Bezos wanting to get into healthcare isn't surprising, I'm saying the timing is merely suspect.
steele said @ 8:44pm GMT on 30th Jan
What are you talking about? They're part of the reason the government isn't doing it.
bbqkink said[1] @ 10:59pm GMT on 30th Jan
That would be insurance and Pharma companies. Big business wants MFA as much as I do. Take the expense off their payroll and put it where it belongs. GM pays more for insurance than they do for steel.
steele said @ 11:33pm GMT on 30th Jan
bbq, you can't watch people spend millions of dollars disassembling our government's ability to get shit done and then be like "No, no, these guys are only anti-union. It's the other billionaires that have made our government unable to pass single payer." It all leads to the same ineffectual government.
bbqkink said @ 12:54am GMT on 31st Jan
But they will always act in their own self interest. It just so happens that this time their interest and ours align. I have no illusions that they are being Benevolent or that they wouldn't turn the whole system upside down to create a quick profit.
steele said @ 1:11am GMT on 31st Jan
Their self interest is cutting their own costs, not lowering their employees' costs. Not lowering our costs. All you've got is a vague press release and you're already talking about them proving nonprofit healthcare works. This is much more likely about cutting their own costs while getting access to vast amounts of profitable healthcare data before single payer and HIPAA puts it out of reach. Don't be surprised if we start seeing attacks on HIPAA 'for our own good.'
bbqkink said[2] @ 1:39am GMT on 31st Jan
Damn you are more cynical than I am ..and I'm old.
And like I said this will not lower "our"cost it will raise them. This will allow them to give their employees medical coverage and a lower cost to them...the rest of the insurance market will see rising cost as more people leave leave the risk pool.

This in combination with the the fuckery with the ACA will see a much smaller risk pool. increased hospital cost as the emergency rooms become primary medical care facilities again.
steele said @ 2:42am GMT on 31st Jan
I'm not being cynical. I'm familiar with the mindset coming out of Silicon Valley. For example, from the podcast midden posted the other day.

Jaron Lanier: The first thing I want to do is just confirm the degree of problem that exists... I still kinda have my meal card in Silicon Valley despite of all the things I say and so I'm in these conversations sometimes and I hear people who have done extremely well and have a lot of influence in Silicon Valley say things that just... send me reeling. Because they're just so appalling. And so a fairly typical line of conversation lately has gone something like this:

Lanier: Well you know, um automation is coming and a whole lot of people are going to be thrown out of work. Many many millions of people, many hundreds of millions because they won't be driving anymore, they won't be doing so many other things. We think we can have our algorithms be better teachers, better nurses. All, even the sort of supposedly human-centric "safe" things. Or in the worst case, we'll only need a little bit of human labor to cover the rough spots of the algorithms. But the question is what to do with all these people and a lot of them have been saying, "Ya know, this Opioid addiction crisis has come up at just the right time because actually it will be easier for everybody if a lot of the people that aren't needed are just sedated all the time." Like this is actually positive.

Ezra: Do people actually say that to you?

Lanier: Yeah, I've heard that a number of times, it's sort of an internal talking point that comes up. Yeah I've heard that. Yeah um. I mean, I always fight it, but yeah sure, I've heard it. And I'm not saying everybody says it, but I'm saying there's... it's the sort of thing that one hears. And one definitely hears that...

Ezra: I'm completely flabbergasted.

LAnier: Yeah, I know, I know.

Ezra: That another human being would make this comment to another human being.

Lanier: Yeah, I don't want to name the specific people who have done it, but they're known names, you know? And uh, similarly with the idea of technology being addicted, of using the different techniques like noisy feedback which is what's used in gambling to make gambling addictive. Of using these things to addict people to information systems, it's a very similar argument. That we need to have the people in some sort of a "spot" where they're not going to just burn everything down when they don't have jobs. And then um, the basic income model is thought of as a kind of a ma.. It's kind of like in the matrix movies, ya know? It's just this way to maintain this population of people who aren't doing anything and aren't needed.


Lanier isn't some tech support guy, he's a guy of such renown that companies make positions for him just so he'll come work for them. He's straight up old school hacker and even he finds that things in Silicon Valley are getting too out of control. "Benevolence" from Silicon Valley has a price, because as far as they're concerned, you and I and the rest of the population, are in the way of their glory.
bbqkink said[3] @ 3:48am GMT on 31st Jan
Well any sort of bubble allows you to view things outside of the bubble as trivial and unnecessary. And if you are smart enough to make grand plans you see unnecessary things as obstacles and deterrents. Its just that I don't think their grand plans are inevitable or even valid out side the bubble.

Oh they are rich and have power but the best laid plans...have a way of looking like pipe dreams in the mirror of history. things come along like gun powder or microchips that change everything.
midden said @ 5:06am GMT on 31st Jan
As with evolution itself, there is no long term goal, thanks in great part to the power of quarterly filings, returns, and dividends. You are absolutely right, though, that the goal is cutting costs and grater profits, not the well being of employees. Short term, that may lead to lower expenses and healthier employees, but I have no illusions that in the mid to long term that this path is for the greater good. I'm not sure why you, steele, seem to think that I, or bbq, or anyone is saying that what Amazon and the rest are proposing is a good solution to our nations seriously fucked up addiction to healthcare as a source of wealth and profit. It's almost certainly not a good solution for the citizens at large, (unless it can somehow be miraculously shifted to a larger, society wide, not for profit solution, which seems very unlikely). But for the short term survival of the "fittest" corporate beast, it makes perfectly good sense. I don't see how anything Lanier says in that interview is contrary to that low level driving force guiding corporate behavior.
steele said @ 1:42pm GMT on 31st Jan
Except there is a long term goal, it is disruption and consumption, that's the Silicon Valley way. That's what Lanier discusses that's so important, understanding the ideology that fuels their actions.

I'm not saying you're saying it's a good thing, I'm saying you're not being wary enough of the actions being made by the people tearing this country apart. Because whether or not it's a good solution for the citizens at large, doesn't matter. If it cuts healthcare costs in any way, even just for corporations, I guarantee you it will be used to undermine the single payer movement. It will be flashed all over our news sites, television screens, and facebook feeds as a success of the private market. I'm watching this shit go down on my facebook right now as there's a war going on in the UK between doctors and nurses in the NHS and people who are inadvertently undermining their own NHS while going on about how much faster their private insurance experience is while ignoring the budget slashes that they allowed that fucked their NHS in the first place. We don't live in a bubble, I'm not playing Oracle here, I'm just pointing out how this has gone down before. How this is going down now. The war for the Overton Window is playing out all around us, and we are just as much a part of it, as we are the traffic when we are stuck in traffic.
bbqkink said[1] @ 12:14am GMT on 1st Feb [Score:1 Underrated]
steele said @ 1:43am GMT on 1st Feb
Dozens of us!
HoZay said @ 4:18am GMT on 1st Feb
Also, probably, everyone who actually works in health care, where consolidation, cost-cutting, overworking staff have been the norm for a few years now.
steele said @ 4:35am GMT on 1st Feb
Sadly, working in healthcare doesn't preclude someone from a background of misinformation.
LurkerAtTheGate said @ 3:06pm GMT on 30th Jan
Sure. For that matter, why bother with pesky taxes - redeem part of your paycheck pre-tax in Prime-scrip, redeemable at Prime-Health, Prime-Foods, Prime-Video, Prime-Fashion, or anything else on Amazon.com!

There's a decent chance this could still provide better quality of service than current for-profit providers.
midden said @ 3:15pm GMT on 30th Jan [Score:1 Underrated]
Tessier-Ashpool, Ono-Sendai?
eggboy said @ 3:23am GMT on 31st Jan
My thoughts exactly.

Maybe Bezos is Hualpa
steele said @ 5:00pm GMT on 30th Jan
Are you enjoying your Prime News Article, Prime Citizen?
milkman666 said @ 6:07pm GMT on 30th Jan [Score:3]
"Woah Woah! Put your guns down! I'm not tresspassing!"
"Submit to a scan!"
"Sure ok. Wait! Wait! I know what it says on the fire tablet, my case is undergoing resolution by a customer service representative, you can call the Grand Arbitrator of this section. Its an ongoing case!"
"You are not a shareholder."
"My parents were, i was conceived in a company car and born in a subsidiary Hosp-corp. I even had amazon coins. I used them to expedite my case"
"You will come with us, even as a shareholder you would need to be a prime plus tier to be out after curfew. While we review this matter you will work off your fine in a mechanical turk.
*far off explosions* . Shit! Get out of here, it's a Muskivite raid!"

"FOR ELON!" *pulls out tesla flamethrower* *Spits hot electric fire*
steele said @ 7:13pm GMT on 30th Jan
This seems very likely. The cult of personality growing around Elon is some dangerous shit, and he's already arming them. :P
HoZay said @ 6:03pm GMT on 30th Jan
Primate
midden said @ 3:11pm GMT on 30th Jan
You could certainly look at it that way. Or that they're bleeding profits like mad due to their employee's benefits packages and have decided the most effective solution is tackling the problem themselves. I'm thinking it's harkening back to the days of the early mid 20th Century company towns and forward toward the Corporate States of Neuromancer. Not that either is a better option than a properly run medical care system owned by the society at large, but I think, "trying to undermine the medicare movement," is a bit tinfoil hat-ish.
LurkerAtTheGate said @ 3:19pm GMT on 30th Jan
Worth noting that most Insurance companies are doing this already with Insurance Provider-owned "teladoc" systems; Co-pays are gone so doc visits are pricey, but calling BCBS-Teladoc is free for every member of the family! Not far from all medical claims being refused unless run by Teladoc first.

It drives me nuts that the company is Teladoc, not Tele-doc.
mechanical contrivance said @ 3:41pm GMT on 30th Jan
As in tell a doc?
midden said @ 4:47pm GMT on 30th Jan
"drive-thru"
steele said @ 4:59pm GMT on 30th Jan
The Bezos owned Washington Post ran 16 negative Bernie Sanders stories in 16 hours in the midst of the Democratic Primaries. In America, politics is business and business is politics. I'm not saying that's the only reason behind this move, but the Silicon Valley ideology that Bezos follows would see the medicare for all movement as an attack on their territory. Bezos was already going after shipping and logistics, healthcare doesn't seem farfetched, but I'd bet the timing is not coincidental.
midden said @ 7:46pm GMT on 30th Jan
I agree that it's corporate self interest, but I tend to favor the simpler, more direct causes before the more complicated conspiracies. Not that the more complicated explanations are always wrong, but Occam's Razor is a pretty good rule of thumb to follow.
steele said[1] @ 8:42pm GMT on 30th Jan
See, i don't see, "They're coming for our cash cow, we better do something!" as being all that complicated.

I mean according to your WP article, this is day one. Nothing more than a press release so far.
midden said @ 10:00pm GMT on 30th Jan
But medicine is not their cash cow. Their cash cow as the near monopoly they've already got going via their existing retail and cloud businesses, but there is a huge drain on their profits in the form of medical insurance.
steele said @ 10:07pm GMT on 30th Jan
Their cash cow is the private market. Any step towards government regulation or nationalization is a threat towards their ideology. These are the 'my charity foundation is better than a government program' crowd.
steele said @ 5:10pm GMT on 30th Jan
Btw, did you listen that Ezra podcast you posted?
buckaroo50 said @ 8:21pm GMT on 30th Jan
This is basically how Kaiser Permanente got started.

https://en.wikipedia.org/wiki/Kaiser_Permanente#History

Now they're one of the most affordable and well liked health care options out here. I for one would love to have health insurance included with my Prime membership :)
steele said @ 8:50pm GMT on 30th Jan
Check the controversies section, KP is not without its faults. The issue is that bandaiding the approach to healthcare while undermining the single payer approach is still incredibly detrimental to the millions who have to go without in what is a pretty well rigged system. Not to mention, all of us who aren't billionaires have no protections from the billionaires thanks to them lobbying away the government restrictions that got in the way of their "benevolent visions."
midden said @ 10:03pm GMT on 30th Jan
Kaiser is a pretty good model of what a nationalized system could be.
steele said @ 10:13pm GMT on 30th Jan
So lets add a bit more oversight to KP, nationalize it, and expand it. ;)
midden said @ 10:52pm GMT on 30th Jan
I'd be all for that. I'm not arguing in favor of what Bezos & Friends are doing, just saying that it doesn't have to be a big conspiracy to make good business sense.
steele said @ 11:53pm GMT on 30th Jan
Them doing what they've been doing is not a conspiracy theory. This is the usual neoliberal bullshit. All i'm saying is the timing make it's pretty suspect that in the midst of a movement for single payer taking hold they've suddenly decided that now is the perfect time to do something. I think you're being way too trusting if you don't think one has created an urgency for the other. This is the exact sentiment I'm talking about and it's at the core of how neoliberals privatize while still claiming to be whatever party they belong to. This is how we ended up with an ineffectual NASA, an ailing USPS whoring itself out to the private delivery companies, and a joke of a public school system.
midden said @ 12:57am GMT on 31st Jan
I admit I tend to err on the side of trust. As someone I respect once said, "Be the porn you want to see in the world." :)
steele said @ 1:00am GMT on 31st Jan
You letting yourself get fucked by billionaires isn't quite the porn I had in mind.
arrowhen said @ 3:02am GMT on 31st Jan [Score:2 Underrated]
midden said @ 5:06am GMT on 31st Jan
Yeah, my pecs and abbs are just like that.
arrowhen said @ 8:41am GMT on 31st Jan
Like the dinosaur's?
King Of The Hill said @ 4:20am GMT on 31st Jan
They aren't doing anything too radical.

My employer is gigantic... and used to be bigger. They are a self insurer for health care. The only reason they deal with the various BCBS, Cignas, United, etc is for the middleman and the network shit. My employer pays them a fee but pays their share for every surgery, etc.

If Amazon, JP Morgan and Buffett find a cost effective way to chase the middle men out of insurance, pharma, etc then I call that a fucking win for everyone.
steele said @ 4:47am GMT on 31st Jan
I mean, according to the article they aren't doing anything at all. This is still nothing more than vaporware. It's the baseless, benevolent projections people are putting on this that are driving me nuts.
King Of The Hill said @ 5:34pm GMT on 31st Jan
I get that, but there is something to it.

These three companies collectively have a lot of power and expertise in what they do. Amazon is already making subtle moves in healthcare. Buffet is well versed in acquisitions and has the liquidity to pull off some big ones. JP Morgan can under write it all.

The next few years will see some interesting acquisitions by both Amazon and Buffett in the healthcare and pharma space. Trust me on this. Even without this article talking about the triad of companies finding their own solution, Amazon's next logical step is going this direction anyway.
steele said @ 5:48pm GMT on 31st Jan
Oh, I totally agree on it being the next logical step. No doubt. That was clear when they started making moves on the logistics and shipping. I just happen to think the medicare for all movement pushed up the timetables. Hence the haphazard announcement.
norok said @ 4:28pm GMT on 30th Jan [Score:-3]
filtered comment under your threshold
bbqkink said @ 7:56pm GMT on 30th Jan [Score:-1]
filtered comment under your threshold
perezoso said @ 9:37pm GMT on 30th Jan [Score:1 Underrated]
Our government has become so dysfunctional on this issue that we are forced to place hope in monopolists coming up with a 'better' solution. Whatever the eff they do, they can't make it any worse. And there's a small chance they will make it better. This from a charter member of Obamacare (wife has 'pre-existing condition') who has long favored a nationalized healthcare system.
midden said @ 12:59am GMT on 31st Jan
I wouldn't call it a better solution, more of a finger in the dike solution.
C18H27NO3 said @ 5:15pm GMT on 31st Jan
The whole idea behind making government dysfunctional is to prove that the private sector can do it better. And they are getting their wish. Just look at the "infrastructure plan."
steele said @ 11:27pm GMT on 30th Jan [Score:1 Funsightful]
steele said @ 3:02pm GMT on 30th Jan
And I realize I'm a broken record, but we are very much becoming a Conglomeration Nation. An evolution of the company towns that plagued America with a form of wage slavery and company fealty that was practically inescapable.
midden said @ 3:13pm GMT on 30th Jan [Score:1 Funsightful]
You beat me to it! That's exactly what I was responding to your first comment.
arrowhen said @ 5:29pm GMT on 30th Jan
I really hoped this cyberpunk dystopia would have more mirrorshades and razorgirls.
midden said @ 7:51pm GMT on 30th Jan
Don't fret; Gibson says he imagines Neuromancer takes place in the mid 2030s, so we still have a little over a decade.
satanspenis666 said @ 5:57pm GMT on 30th Jan
I see several pros and cons with this. Ideally if a corporation is creating an insurance company, it is in their best interests financially. If a company is paying a 20% premium to an insurer and they could offer the same service at a lower cost, it will save money. If they can do it for the same cost and reduce their taxes, it will save money. Most likely, there are a limited number of insurers (monopoly) that are actively increasing costs and not negotiating fairly. The only way to play this game is to change the rules; you don't negotiate with me, you won't get my business (win/lose).
C18H27NO3 said @ 5:20pm GMT on 31st Jan
In the end it will only be the "perception" of being better. Like people making $60K living in an urban area getting a $1000 bonus. It's not like that $1000 is going to make an effective difference, but it allows you to buy a shiny new smart phone and a night out on the town. I mean, that's what you want, right?

Oh, and government handouts are ok if called "tax reform" instead of entitlement programs.
steele said @ 5:55pm GMT on 4th Feb

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