Amazon, Berkshire Hathaway, JPMorgan Chase announce new health insurer 'free from profit-making incentives and constraints'


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Or they could simply pledge to pay their workers health bills, make agreements with health providers near their businesses to adjust 50%-80% of the bill which is within the customary adjustment range, and save on the cost of healthcare.


If this didn’t involve Amazon (“we’ll save on money on aircon by having our employees drop from heat stroke!”), I’d be a lot less cynical about this.


It’s easy to be cynical about this, but I think getting big money to proof-of-concept a new way to run healthcare is the most likely way we’ll see meaningful change. I don’t expect we’ll see anything backed by lawmakers anytime soon that is an actual improvement.


There’s not enough information here to be critical. We don’t know what they intend to do, just that they intend to do something. That is good news in my book. I’m cautiously optimistic and I’m happy that somebody is trying something, anything really, to fix the system.


A very brief note on the potential impacts of this:

  1. It’s worth bearing in mind that healthcare is something like 11% of the U.S. economy, and has been one of the main sectors soaking up all the displaced workers, and certainly the one that pays far better than the other ones.

  2. Displacing a decent chunk of these workers will certainly drive down healthcare costs, but there’s no sectors left to absorb them all, and almost all the ones that are absorbed into others will take pay cuts. This will have serious economic effects if not planned for.

  3. Therefore, any measure that is likely to have a disruptive impact on the healthcare market must be coupled with measures that are planned for dealing with this major displacement secondary effect, or else we’re going to see it doing a lot of unintended economic damage.


Maybe we could train half of them to repair windows and the other half can be tasked with breaking windows.


To be clear, I hate the “broken window” make-work jobs, because they’re wasteful and inefficient.

I’m not saying we shouldn’t fix U.S. healthcare delivery and cost, because we totally should. We just need to be careful that we don’t fuck ourselves sideways doing it; treat it more like defusing a bomb than squishing a bug, you know?


Kaiser Permanente, one of the biggest health insurers in the country, was kick-started by wealthy industrialist Henry J. Kaiser. So it can be done.


Kaiser is a great example because it’s already doing part of what it sounds like these guys want to do - vertically integrate.


I’d still be cynical about it, with Buffet and Diamon. Still wealthy billionaires…


Yeah, and Kaiser sucks at it. Everything is in-their-house. Good luck trying to find a convenient office or one that looks like it’s been updated since 1980. Doctor turn over is high so one day you have a primary and the next you don’t. Health care on an island is far from perfect.


Are you willing to make any concessions for lower health care costs?


No. It shouldn’t be up to the consumer to make sacrifices when it comes to health care. HC providers and Big Pharma make money hand over fist and they have much more leeway than consumers when it comes to making concessions. Let them sacrifice profit for the greater good. Concessions on the consumer end should only consist of doing their best to stay healthy.

If these guys are serious about “free from profit-making incentives and constraints” more power to them and I wish them all the luck.


Healthcare is not the same as health insurance. I don’t see how this would end up “displacing a decent chunk of these workers.” Whether the hospital (and therefore the doctors, nurses, technicians) get paid through one health insurance scheme or another won’t change the number of nurses, doctors, or technicians.


Who Insures John Galt?


there are a lot of people making a living in healthcare who have no hands on role in patient outcomes. I’m thinking shareholders and also anyone who does paperwork. If we’re looking to save -cost- we look at who takes the cream off the top. If we’re looking to save -money- we look at who isn’t needed at the bottom end, and who we can exclude from the coverage pool.

Where do you suppose this venture will look to save costs?


I would think you would be a bigger fan of Kaiser then. A big chunk of the group is a non-profit (they are the biggest non-profit in the US) and doctors are paid a salary rather than getting a fee for each service. When doctors make more money by ordering more tests guess what happens - lots of costly and unnecessary tests are performed. I don’t know what Bezos et al are planning exactly, but that kind of decoupling of profit and care is exactly what I think should happen.


Interesting history of Kaiser Permanente. Kinda started off as a workmans’ comp program.


i’m not sure about your experience, but all my friends and family who have had Kaiser love it. I know two physicians who work for Kaiser, and they love it, too. They actually get to be physicians instead of data entry administrators or small business owners.