dagblog - Comments for "Amazon, Berkshire Hathaway and JPMorgan Team Up to Disrupt Health Care"

This example from CNBC makes

artappraiser — Wed, 07 Feb 2018 04:45:05 +0000

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

This example from CNBC makes it clear with them devoting time and money to a whole project on topic, with a conference and all, that this is what lots of business people are interested in. They are trying to get objective analysis with the following selfish motive: They hope to be able to predict where it's going, whether growth in share of economies worldwide is going to rise unabated, what system is going to win, or is someone is going to come up with a better system, etc.

CNBC/Healthy Returns sub-section/Investing in Health Care Innovation

The real reason health care is bankrupting America

The United States spends more on health care than any other nation on the globe.

A shift toward a value-based approach and away from the fee-for-service system is the most effective way to lower overall costs.

Dr. Kenneth Davis is an advisory board member for Healthy Returns, CNBC's new health-care innovation conference that will take place March 28, 2018, in New York City.

hah, good one.

artappraiser — Wed, 07 Feb 2018 03:52:10 +0000

In reply to But compared to the US, on

hah, good one.

Where I am coming from: fighting yesterday's propaganda wars isn't going to cut it anymore. That Trump uses old propaganda about this topic doesn't mean it's smart to fight back with old propaganda as everyone knows by now that he understands zip about health policy issues. Even the fans know something went wrong with delivering on the "repeal and replace" front....

Even the "nobody's complaining over there" argument has a new answer "well, nobody's complaining about their employer provided coverage either". Except the employers. Who aren't the favorites of lefties and vice versa.

But compared to the US, on

CVille Dem — Wed, 07 Feb 2018 03:02:05 +0000

In reply to On Canada, I was referring to

But compared to the US, on this continent with all its corruption and BS, it is still better than we are.

A few years ago I was searching for better infertility drug prices for patients in my practice. The EXACT SAME DRUGS, made by the exact same drug companies could not be ordered because the USDA could not vouch for them. It was total BS.

I wrote a little blog at the time about how I spent 2 weeks in Canada and never once had to move my car out of the way to avoid dead Canadians who had taken Canadian medications.

On Canada, I was referring to

artappraiser — Wed, 07 Feb 2018 02:15:36 +0000

In reply to Good points, AA, but I

On Canada, I was referring to the bad outcome for expenditure scores their system just got on the Commonwealth report for 2017 as opposed to U.K., Australia, the Netherlands, NZ, Norway, Switzerland and Germany. They and France are down signficantly below the others, only above us at rock bottom. See the link and graphics downthread.

Just checking googling now, it's not like no one is complaining up there about how much it costs and what they are getting for it and how they are going to pay for it.

Sorry, I don’t see it. The

CVille Dem — Wed, 07 Feb 2018 01:23:14 +0000

In reply to But CVille, it does inform on

Sorry, I don’t see it. The requirement for Part A to be “No Charge” is to have worked at a job that paid into FICA for 10 years. My daughter worked for a Vet when she was 15, and paid into FICA from the get-go. My sons came along later, and didn’t start paying in until they were 18.

Ten years? Most 60-something’s have most likely worked at least 10 years.

But CVille, it does inform on

artappraiser — Wed, 07 Feb 2018 01:04:25 +0000

In reply to Paying premiums for Part A

But CVille, it does inform on how much it actually costs. It's the current value that the government puts on that coverage which the qualified receive without further charge, for the money they paid into in their lifetime. Therefore, if people like the idea of offering "buy into Medicare" for other age groups, one can presume buying in to the Part A hospital insurance would cost at least that much.

Edit to add: It is often suggested that the first group to be allowed to buy into Medicare as like a "public option" would be those like 60 and over, because they tend to access more health care, to get them out of the general population pool. So that makes it an even more accurate estimate. And again, that's just for hospitalization: $411 a month.

It informs a lot, I would say. It's also informative of other things, like: how much hospitals are feeding the rapid rise in costs. This is a government figure, for plain vanilla coverage, without any insurance company profiting.

Paying premiums for Part A

CVille Dem — Wed, 07 Feb 2018 00:44:44 +0000

In reply to Here's what the actual cost

Paying premiums for Part A (hospital insurance). If you have fewer than 30 work credits, you pay the maximum premium, $411 in 2016.

A person earns 4 credits each year of employment. Someone at the age of 65 (the age of eligibility for a non-disability claim for Medicare), who had 30 credits would have worked 7.2 years in 65 years. Any person who has worked 10 years in their life (and paid into FICA) pays ZERO for Part A.

Most people who collect Social Security pay nothing for Part A because the requirement is simply to have worked 10 years. (Disability requirements are different).

I really think that this worst case scenario does not help inform.

Single-payer health care

HSG — Wed, 07 Feb 2018 00:40:30 +0000

In reply to You're right that B,B and D

Single-payer health care systems provide better outcomes for less money. So your fear of massive tax increases is unfounded.

Good points, AA, but I

CVille Dem — Wed, 07 Feb 2018 00:26:07 +0000

In reply to You are misreading what Peter

Good points, AA, but I disagree on some points.

-As to reducing costs by negotiation, I am constantly amazed when I look over my “This is not a Bill” statements. Procedures that are billed at, say, $140 often have the “Allowed amount” as $39, and “Amount paid” at $11. My husband gets a treatment every 3 months that is billed at $275, but ultimately gets a payment of about $20.

I don’t see how further negotiations would be possible. We are both on Medicare with supplemental coverage.

-As to jobs, OBAMACARE increased health-care Jobs, and saved many (rural) hospitals from folding. The latest GOP attacks and sabotage are reversing that trend. Yes, it’s true that the pencil-pusher who currently works for an insurance company, and whose job it is to figure out a way to decline coverage will likely not be re-employed as a care-giver. But which job is more valuable to our society? The care-giver or the care-denier? And for sure, health care access to all means more jobs in health-care.

-As to home-health workers being paid less than hospital workers, well...hospitals are increasingly becoming highly specialized therapeutic centers. Each hospitalized patient is visited each day by multiple professionals who monitor their care. Home-health Care is not a substitute for that; it is a substitute for a nursing home, or other rehab. Only stabilized patients are discharged to Home Care. The RN’s who do Home Care are very well compensated, but they do the jobs of several people (nurses, physical therapists, nutritionists, and more), so overall it is still a bargain.

This is the place where I agree wholeheartedly with you:

Streamlining means not just negotiating with providers but cutting numbers of paper pushers.

My point is that getting rid of advertisers, paper-pushers, and the profit-motive will not produce a net loss of jobs.

As to Canada...Canadians love their health care.

Kind of the opposite, I would

artappraiser — Tue, 06 Feb 2018 21:53:09 +0000

In reply to So do we now have a consensus

Kind of the opposite, I would say. Amazon, Berkshire and JPMorgan have analyzed the situation and decided that there will be no political consensus for the foreseeable future. That they are not going to wait for the consensus, that they think it will profit them to try it themselves right now. And if they are successful, it will help change the consensus, which will be a side benefit, that they will look like good guys for helping to change the consensus. But they are not doing it out of the goodness of their hearts. They are doing it because they believe it can be a "win win" along those lines. The "don't be evil" thing is a marketing side benefit, wil make them look good to like, millennials.

The one deep down ideology they might be pushing here is that they don't believe that the economy should be ever increasingly about health care, that it shouldn't be taking a bigger and bigger chunk of the world's economy. One thing is clear: they will now be the enemy of the smaller start up health care company stocks. And this will accelerate the trend of mergers, like of CVS and Aetna.

The merger mania in health care provider companies does take us down a path where single payer could be easier to enact. But it means a lot of pain, literal and figurative for patients in the meantime. There will be less choice and more bureaucratic hassles in accessing health care. Eventually people get to the point of: would I rather have a government bureaucracy to hassle with to get my prescriptions and tests? I.E., would I rather have a government approved formulary than the CVS-Aetna-Radiology Monopoly's behemoth formulary?