Χά�ων Posted January 30, 2018 Share Posted January 30, 2018 https://www.nbcnews.com/business/business-news/bezos-buffett-dimon-join-create-independent-health-care-company-n842546 Have we talked about this yet? I am reading everything I can on it. Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 30, 2018 Share Posted January 30, 2018 I think it’s for their employees only and not the general public even though that may eventually happen. From BBC http://www.bbc.com/news/business-42877287 “Amazon, JP Morgan and Berkshire Hathaway are joining forces to create a healthcare firm aimed at cutting costs for their US employees. The independent firm would be "free from profit-making incentives and constraints", the firms said. They said their aim was to provide care to staff at a "reasonable cost". ... The firms are the three largest private employers in the US, collectively employing over 500,000 staff. ... "The three of our companies have extraordinary resources, and our goal is to create solutions that benefit our US employees, their families and, potentially, all Americans."†Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 30, 2018 Share Posted January 30, 2018 Mark Merritt, President and CEO of PCMA, a trade organization representing American pharmacy benefit managers. And this quote right here is why I really hope they succeed.[/size] If Jeff B. or Warren B. can build a better mouse trap, I say have at it. Health insurance companies are so corrupt and incompetent. There is no hope......ack. I need to stop now before I go on a rant. Our cost of employer-sponsored health coverage stated on my husband’s W2 is $17,348.55 and his rather big employer had to drive a hard bargain with Blue Cross California and Aetna annually. I also hope they succeed. Quote Link to comment Share on other sites More sharing options...
Pawz4me Posted January 30, 2018 Share Posted January 30, 2018 I wish them lots of success. I want us to get civilized like the rest of the first world and have a Medicare for all or similar type system, but in the meantime anything that can be done to improve our current health insurance/health care situation is good. If nothing else hopefully they'll provide some significant competition for the insurance companies. 10 Quote Link to comment Share on other sites More sharing options...
TechWife Posted January 31, 2018 Share Posted January 31, 2018 I wish people would stop confusing health care with the health insurance industry. They have stated, very clearly, that it is insurance they are after. It really does sound like the three are banding together to provide a self funded insurance benefit for their employees. Companies used to do it all the time. The difference here is that we have innovative thinkers who are willing to look at other options, rather than to continue to play into the health insurance pit. 11 Quote Link to comment Share on other sites More sharing options...
Seasider Posted January 31, 2018 Share Posted January 31, 2018 I am fascinated by the three players involved. It seems like a connection maybe made in an elevator a la Melanie Griffith Working Girl, iykwim. 2 Quote Link to comment Share on other sites More sharing options...
6packofun Posted January 31, 2018 Share Posted January 31, 2018 Well, good luck to them. I refuse to be all that interested in any option that doesn't tackle health care COSTS, transparency about COSTS in the overall system, and address the role of the RUC in what we have to pay. Quote Link to comment Share on other sites More sharing options...
Sandwalker Posted January 31, 2018 Share Posted January 31, 2018 Hmm, this is interesting stuff. The stock market took a hit that is said to be related to this news. Amazon is getting its fingers in so many pies, at some point isn't the M word (monopoly...) going to be brought up? They'll probably do a far better job for far less $. Amazonacare 2019! 2 Quote Link to comment Share on other sites More sharing options...
TechWife Posted January 31, 2018 Share Posted January 31, 2018 I wonder what hospitals in that are in the cities on the "short list" for Amazon's HQ2 are thinking right now. It could break them if this new alliance plays hardball as that office will bring 50,000 jobs to the city that is chosen and that is a lot of negotiating power for the employer to have with an independent hospital. I think it may also play into more hospital mergers so that hospitals will have negotiating power in the areas where these employers have a relatively smaller number of employees than in larger cities. On the other hand, If there is only one hospital or hospital system in the area, then will they really have any negotiating power? If there are multiple hospitals, then they will have more power and the hospitals will have less. I think they are going to learn that it is quite a trick to balance employee healthcare needs with availability of necessary facilities, also. Next up, will Amazon start buying up hospital systems? 1 Quote Link to comment Share on other sites More sharing options...
Pawz4me Posted January 31, 2018 Share Posted January 31, 2018 I am fascinated by the three players involved. It seems like a connection maybe made in an elevator a la Melanie Griffith Working Girl, iykwim. One article I read said they've known each other a long time and have talked frequently for years. 1 Quote Link to comment Share on other sites More sharing options...
creekland Posted January 31, 2018 Share Posted January 31, 2018 I saw a short report on NBC about this. Add me to those hoping they succeed. It seems like they have more than their employees in mind. They seem to want to rework the whole thing to help all Americans should Americans want to use them once they have it figured out. Of course, part of me thinks they're just after the money themselves (rather than being altruistic) since they noted that Americans pay the most per capita for healthcare at roughly $10,000. If they can do it for $8,000, they'll profit considerably just as the big giants are doing. Undercutting each other is what businesses do. OTOH, anything that lowers things for the bulk of the people and still provides decent care is better than what we have now, so I'm still hoping they succeed. No sense continuing to provide the current giants with their excessive profits. Health care isn't a want. It's a need. 4 Quote Link to comment Share on other sites More sharing options...
Crimson Wife Posted January 31, 2018 Share Posted January 31, 2018 Well, good luck to them. I refuse to be all that interested in any option that doesn't tackle health care COSTS, transparency about COSTS in the overall system, and address the role of the RUC in what we have to pay. I refuse to be interested in any option that focuses on cutting COSTS rather than on what is best for the individual patient. I don't want my child's well-being to be sacrificed in the name of saving money. Transparency? Absolutely! I should be able to find out before agreeing to a test or procedure exactly what the costs are going to be. I can go to Directlabs.com or one of its competitors and be able to look up exactly what my cost would be for a particular lab test. But if I order it through my doctor? I have no clue until AFTER the testing is done and the bill comes due. Wrong, wrong, wrong! 4 Quote Link to comment Share on other sites More sharing options...
Bootsie Posted January 31, 2018 Share Posted January 31, 2018 I think it’s for their employees only and not the general public even though that may eventually happen. From BBC http://www.bbc.com/news/business-42877287 “Amazon, JP Morgan and Berkshire Hathaway are joining forces to create a healthcare firm aimed at cutting costs for their US employees. The independent firm would be "free from profit-making incentives and constraints", the firms said. They said their aim was to provide care to staff at a "reasonable cost". ... The firms are the three largest private employers in the US, collectively employing over 500,000 staff. ... "The three of our companies have extraordinary resources, and our goal is to create solutions that benefit our US employees, their families and, potentially, all Americans."†How can the bolded be correct? Wal-mart has over twice that many employees in the US. Quote Link to comment Share on other sites More sharing options...
Lady Florida. Posted January 31, 2018 Share Posted January 31, 2018 I think it’s for their employees only and not the general public even though that may eventually happen. There's speculation that they will try it out on their own employees and if it's successful they could open it up to the general market (according to the NBC link in the OP). 3 Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 31, 2018 Share Posted January 31, 2018 How can the bolded be correct? Wal-mart has over twice that many employees in the US.Someone at BBC didn’t do their homework :P From Walmart https://corporate.walmart.com/newsroom/company-facts “Walmart employs 2.3 million associates around the world -- 1.5 million in the U.S. alone. About 75% of our store management teams started as hourly associates, and they earn between $50,000 and $170,000 a year — similar to what firefighters, accountants, and even doctors make.†1 Quote Link to comment Share on other sites More sharing options...
Pawz4me Posted January 31, 2018 Share Posted January 31, 2018 They may have meant full time employees. I bet an astronomical percentage of Walmart employees are part time. 6 Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 31, 2018 Share Posted January 31, 2018 There's speculation that they will try it out on their own employees and if it's successful they could open it up to the general market (according to the NBC link in the OP).They would definitely use their employees as guinea pigs. It’s the opening to the general market that is up to speculation. I had company doctors on site when I worked for HP decades ago so I’m not surprised that employers would want some control over healthcare cost other than haggling annually with Kaiser, CVS/Aetna, BCBS, etc. for their employee healthcare plans. After all Kaiser Permanente started originally to provide healthcare to their Kaiser Oregon shipyard workers. From CNBC https://www.cnbc.com/2018/01/30/what-amazon-told-employees-today-about-its-deal-to-improve-healthcare.html “Here's the full text of the email Amazon shared with its employees about the partnership: Fellow Amazonians, I want to share with you a new initiative we're undertaking in partnership with Berkshire Hathaway and JPMorgan Chase. We will be working together to improve healthcare for all of our U.S. employees and reduce costs. This initiative will take a considerable amount of time, and nothing is changing with our current healthcare offering. We will let you know well in advance of any changes. Thank you, Beth Galetti†Quote Link to comment Share on other sites More sharing options...
Bootsie Posted January 31, 2018 Share Posted January 31, 2018 I wish people would stop confusing health care with the health insurance industry. They have stated, very clearly, that it is insurance they are after. It really does sound like the three are banding together to provide a self funded insurance benefit for their employees. Companies used to do it all the time. The difference here is that we have innovative thinkers who are willing to look at other options, rather than to continue to play into the health insurance pit. Where have they stated that they are after insurance? I have read the press release and I do not see anything that deals with health insurance: "The initial focus of the new company will be on technology solutions that will provide U.S. employees and their families with simplified, high-quality and transparent healthcare at a reasonable cost." https://www.businesswire.com/news/home/20180130005676/en/Amazon-Berkshire-Hathaway-JPMorgan-Chase-partner-U.S. The announcement says they come to this problem without answers and with a beginner's mind; this sounds as if they are exploring issues and do not have a concrete plan at this point. 3 Quote Link to comment Share on other sites More sharing options...
Lady Florida. Posted January 31, 2018 Share Posted January 31, 2018 It really does sound like the three are banding together to provide a self funded insurance benefit for their employees. Companies used to do it all the time. The difference here is that we have innovative thinkers who are willing to look at other options, rather than to continue to play into the health insurance pit. Government agencies too. I don't know if it's still the case but the school system where I taught had self funded insurance. I left in 1997 when ds was born so I don't know if it changed but it was the case for the 12 years I taught in this county. This though, is different than just self funded insurance. These guys want to effect change in a good way. I hope they succeed. 4 Quote Link to comment Share on other sites More sharing options...
Bootsie Posted January 31, 2018 Share Posted January 31, 2018 80% of employers with over 500 employees self-fund their insurance (https://www.investors.com/politics/commentary/self-insured-companies-help-push-health-care-innovations/) and it has become more popular with smaller employers. Often an insurance company adminsters the plan for the company. 3 Quote Link to comment Share on other sites More sharing options...
TechWife Posted January 31, 2018 Share Posted January 31, 2018 Where have they stated that they are after insurance? I have read the press release and I do not see anything that deals with health insurance: "The initial focus of the new company will be on technology solutions that will provide U.S. employees and their families with simplified, high-quality and transparent healthcare at a reasonable cost." https://www.businesswire.com/news/home/20180130005676/en/Amazon-Berkshire-Hathaway-JPMorgan-Chase-partner-U.S. The announcement says they come to this problem without answers and with a beginner's mind; this sounds as if they are exploring issues and do not have a concrete plan at this point. You are right, their statement does say the will address health care. It also says that they will be tackling healthcare costs. In order to do that, they will have to address insurance, I don’t see a way around it. News outlets are also discussing their announcement in the same breath as insurance, so I know I’m not the only one who thinks that way, at least. Quote Link to comment Share on other sites More sharing options...
Bootsie Posted January 31, 2018 Share Posted January 31, 2018 Berkshire Hathaway already has a great deal of involvement in the insurance industry. For example, through Central States Indemnity, it offers medicare supplemental insurance, through Gen Re it offers reinsurance, and it recently bought a company that provides medical malpractice insurance. 1 Quote Link to comment Share on other sites More sharing options...
TechWife Posted January 31, 2018 Share Posted January 31, 2018 I wonder if they're looking at the one-stop model CVS is trying to incorporate. Doctor, pharmacy- RX and OTC, all of it in one location and cut out the middle man. Isn't this the Kaiser model as well? Or do they not do pharmacy? Quote Link to comment Share on other sites More sharing options...
Bootsie Posted January 31, 2018 Share Posted January 31, 2018 That's why I suspect some conflict of interest issues are going to crop up sooner than later......they're heavily invested in the very products they're about to try and undermine. I don't get how that will work- although I definitely wish them well. But I can't wrap my head around it. And JP Morgan has 74% of the top 100 insurers globally as customers, providing investment solutions for them. https://am.jpmorgan.com/us/institutional/our-clients/insurance-companies-us-ca Quote Link to comment Share on other sites More sharing options...
Arcadia Posted January 31, 2018 Share Posted January 31, 2018 Isn't this the Kaiser model as well? Or do they not do pharmacy? I'm not sure- we don't have Kaiser in this area, but when CVS put in the bid for Aetna last month my radar shot up for sure. Kaiser has pharmacies in their medical centers and hospitals. I was considering them for obgyn but went with BCBS. Quote Link to comment Share on other sites More sharing options...
Carol in Cal. Posted January 31, 2018 Share Posted January 31, 2018 Right. I used to work for a Large Tech Firm, and although they used BCBS to manage their claims, they self-funded entirely. I wish people would stop confusing health care with the health insurance industry. They have stated, very clearly, that it is insurance they are after. It really does sound like the three are banding together to provide a self funded insurance benefit for their employees. Companies used to do it all the time. The difference here is that we have innovative thinkers who are willing to look at other options, rather than to continue to play into the health insurance pit. Quote Link to comment Share on other sites More sharing options...
Carol in Cal. Posted January 31, 2018 Share Posted January 31, 2018 Isn't this the Kaiser model as well? Or do they not do pharmacy? I have Kaiser. They do pharmacy, optical, and medical, including emergency room and urgent care as well as primary and specialty care. Since they are an HMO, a lot of the regulations around the ACA don't apply to them. For instance, they are not required to cover adult children to age 2X if they are not living in one of the HMO service areas, except for reimbursement of urgent care and emergency room services from other providers. I don't believe that they offer dental care as an option. Other than that they are pretty comprehensive. They also have a Medicare Advantage program that is pretty well-regarded. Quote Link to comment Share on other sites More sharing options...
Crimson Wife Posted January 31, 2018 Share Posted January 31, 2018 Isn't this the Kaiser model as well? Or do they not do pharmacy? Oh, no, Kaiser has its own pharmacy. Where you will be stuck waiting in crazy lines only to half the time get up to the front & find out that whatever medicine you need is out of stock and you'll have to wait a week to get it. And you cannot just take your prescription and go to the local Walgreens/RiteAid/CVS/Target/etc. because then you'd have to pay 100% out of pocket because you went to a non-Kaiser pharmacy. :cursing: There are MANY reasons I hated having Kaiser but all the time wasted at their pharmacy is one. 1 Quote Link to comment Share on other sites More sharing options...
LucyStoner Posted January 31, 2018 Share Posted January 31, 2018 I don’t think there’s enough details to get either worried or optimistic over. If it’s a provider network, I would be concerned about the company store aspects of it. My husband and his adult dependents (so that would be me) do have access to a free employee clinic but we go elsewhere anyways because, well, no one needs their employer knowing exactly what healthcare they get. While we know it is separate, it doesn’t seem like a place to where I would be willing to get more than a flu shot. Maybe this conglomeration can overcome people’s objections to that. If it’s just online tools or some such nonsense, meh. 3 Quote Link to comment Share on other sites More sharing options...
LucyStoner Posted January 31, 2018 Share Posted January 31, 2018 I wish people would stop confusing health care with the health insurance industry. They have stated, very clearly, that it is insurance they are after. It really does sound like the three are banding together to provide a self funded insurance benefit for their employees. Companies used to do it all the time. The difference here is that we have innovative thinkers who are willing to look at other options, rather than to continue to play into the health insurance pit. I’m sure that all of these employers are self funded now. I know Amazon is self funded. We are on a self funded plan but it is administered via a major insurance company. 2 Quote Link to comment Share on other sites More sharing options...
Pawz4me Posted January 31, 2018 Share Posted January 31, 2018 (edited) I'm not sure I/we have ever NOT had self funded insurance. DH worked as a contractor once for a year or two. They may not have been. But that's the only time in the past 35 years I can think of that our insurance might not have been self funded. (ETA: And no, I'm not mistyping. DH worked as a contractor a long time ago and it was done through a company that did indeed provide benefits. I know that doesn't happen nowadays.) Edited January 31, 2018 by Pawz4me 1 Quote Link to comment Share on other sites More sharing options...
Pam in CT Posted January 31, 2018 Share Posted January 31, 2018 (edited) The model they're considering isn't clear yet, but as others have noted Amazon has already moved into prescription drugs, Berkshire already does a range of insurance (though I dunno about health), and between the three of them they may well be self-insuring more full-time insured employees than any other private employer. (Walmart may have more employees, but not insured employees.) And unlike Walmart or other large operations, I think (?) most their employees are fairly geographically clustered, which would make them well suited to buy up or partner with health care providers, hospitals and networks, to provide services directly. It's not much of a stretch to visualize a hybrid system where they join together to self fund, Amazon does prescriptions, they partner with providers in high-density employee areas with hospitals and providers in an HMO kind of system, maybe partner with an existing large retail network like CVS for routine flu shots & walk-in care, and have Berkshire manage insurance for anything out of "network." That adds up to a system. With their magnitude and supply chain power, I can see that driving out some cost. To Crimsonwife's point, it wouldn't do much, in and of itself, to improve quality of care. And potentially once it's off the ground, they might decide to let non-employees buy in. Particularly young and healthy folks :rolleyes: to help with the numbers. I do think there would be very real company store / privacy risks with something like that. Sooooooo easy to find a way to lay off an employee, once you know she's carrying the gene for breast cancer or taking medication for depression. Private sector innovation is terrific, yet more so when it's led by clever and innovative people with demonstrated track records. This may very well drive down costs and perhaps even improve care for a sizable cohort of full-time employees of these established major companies. A solid incremental tweak at the margin of a systemic problem, that benefits that cohort of people. It's hard to see, though, how benefits to that cohort could translate over to better health care for the general population. Edited January 31, 2018 by Pam in CT 2 Quote Link to comment Share on other sites More sharing options...
LucyStoner Posted January 31, 2018 Share Posted January 31, 2018 We're on self funded now but administered through a major company too and they are every bit as much of a PITA as just going straight through the insurance company--with the added negative of not being able to file a complaint against them. The State of TX does not deal with complaints against private insurers (according to the letter they sent me when I tried) who simply administer through a large company- even if the large administrating company botches several things during their part. It's just another facet that convinced me how totally corrupt the entire thing is between companies and regulators etc. That’s a Texas thing. Or rather a matter of state law. Here in WA State, the self funded plans answer to the Insurance Commissioner just like the regular policies. Lots of experience on that front. Also, my husband’s employer moved their self funded plan from one insurance company to another, in large part to employee complaints. Before the switch, talking on the phone to Insurance was eating a sizable chunk of my time. Since the switch, very few issues. Quote Link to comment Share on other sites More sharing options...
SparklyUnicorn Posted January 31, 2018 Share Posted January 31, 2018 I wish people would stop confusing health care with the health insurance industry. They have stated, very clearly, that it is insurance they are after. It really does sound like the three are banding together to provide a self funded insurance benefit for their employees. Companies used to do it all the time. The difference here is that we have innovative thinkers who are willing to look at other options, rather than to continue to play into the health insurance pit. Companies still do it. I've worked for self funded companies and my husband currently works for one. 2 Quote Link to comment Share on other sites More sharing options...
TechWife Posted January 31, 2018 Share Posted January 31, 2018 We are stuck with CVS for pharmacy. They won't give me a 90 day supply unless I go to their shop or trust the post office (ha ha out here in opioid land). I can relate! We, too have to use CVS. Our policy does allow a 90 day supply of most medications to be filled there, but for controlled substances, it's mail order only through Caremark. Local fills for that are limited to 30 days. It makes no sense - why would I be less likely to use the medication for nefarious purposes if I only had a 30 day supply as opposed to a 90 day supply? Why is it okay to get a 90 day supply through the mail if you think I'm going to use it for nefarious purposes if I purchase it locally? The only thing I can think of is that it means the local pharmacy can keep smaller quantities on hand, which may lessen the likelihood that they would be robbed. Our service has improved a lot since CVS bought out Target pharmacies. I go to a former Target pharmacy now, and they are fantastic. Many of the people have worked there for several years and they have kept up the good customer service they provided as Target employees. Of course, that doesn't solve the mail order issue! Quote Link to comment Share on other sites More sharing options...
Bootsie Posted January 31, 2018 Share Posted January 31, 2018 We're on self funded now but administered through a major company too and they are every bit as much of a PITA as just going straight through the insurance company--with the added negative of not being able to file a complaint against them. The State of TX does not deal with complaints against private insurers (according to the letter they sent me when I tried) who simply administer through a large company- even if the large administrating company botches several things during their part. It's just another facet that convinced me how totally corrupt the entire thing is between companies and regulators etc. http://www.tdi.texas.gov//consumer/selffundedplans.html Self-funded plans are regulated by federal law, under the jurisdiction of the US Dept of Labor. You can file a complaint through the Dallas Regional office. 1 Quote Link to comment Share on other sites More sharing options...
Crimson Wife Posted February 1, 2018 Share Posted February 1, 2018 I can relate! We, too have to use CVS. Our policy does allow a 90 day supply of most medications to be filled there, but for controlled substances, it's mail order only through Caremark. Local fills for that are limited to 30 days. You are able to get controlled substances mail order? I have always had to go in person to get my DD's ADHD medication because it's classified as a controlled substance. I wind up getting all her other meds filled at the same time since I'm already there. We've had the same rule through multiple different plans (both PPO and HMO) so I assumed it was the law requiring pharmacies to only dispense them in-person. Quote Link to comment Share on other sites More sharing options...
Sandwalker Posted February 1, 2018 Share Posted February 1, 2018 I wonder if they're looking at the one-stop model CVS is trying to incorporate. Doctor, pharmacy- RX and OTC, all of it in one location and cut out the middle man. I do think it's a terrible idea overall for companies to have employees private health data, but that ship has sailed with company managed insurance plans. HIPPAA is a sham- there's no privacy on this stuff anymore. Especially once employees rolled over and handed their FitBit data over to their company to save $40 a month on premiums. I don't see how it could be any worse with these players in it, but maybe I'll be surprised. QFT Quote Link to comment Share on other sites More sharing options...
TechWife Posted February 1, 2018 Share Posted February 1, 2018 You are able to get controlled substances mail order? I have always had to go in person to get my DD's ADHD medication because it's classified as a controlled substance. I wind up getting all her other meds filled at the same time since I'm already there. We've had the same rule through multiple different plans (both PPO and HMO) so I assumed it was the law requiring pharmacies to only dispense them in-person. Yes, we can. Policies do vary by state, perhaps you are in a state that doesn’t allow this. Quote Link to comment Share on other sites More sharing options...
Χά�ων Posted February 1, 2018 Author Share Posted February 1, 2018 You are able to get controlled substances mail order? I have always had to go in person to get my DD's ADHD medication because it's classified as a controlled substance. I wind up getting all her other meds filled at the same time since I'm already there. We've had the same rule through multiple different plans (both PPO and HMO) so I assumed it was the law requiring pharmacies to only dispense them in-person. My state I can but I have to hand deliver the script to the company. They will not accept a fax from the doctor and do not want it mailed in. They are less than 20 miles from my house but it is not worth the headache so I just go to the local pharmacy instead. Quote Link to comment Share on other sites More sharing options...
mamaraby Posted February 1, 2018 Share Posted February 1, 2018 Government agencies too. I don't know if it's still the case but the school system where I taught had self funded insurance. I left in 1997 when ds was born so I don't know if it changed but it was the case for the 12 years I taught in this county. Dh works for county government and the county’s health insurance is self-funded. We didn’t have access to preventative care including vaccinations for anyone over 4 years old until the ACA. We also have a “wellness†program which has changed over the years. They say it’s “optional,†but it’s in effect required if you don’t have the financial resources to pay the penalty. Through semantics, that’s not a penalty, it’s an “incentive,†but again in effect it’s a penalty. I’m dubious about the “wellness†programs. They tend to catch a lot of people with health issues within the first few years, but then costs to administer go up and all of the low hanging fruit is taken care of so, at least in my experience the plan starts to morph. Last year there was no “wellness†plan because the county had difficulties finding a company to administer the plan. This year there is some new company and I find their “wellness†program even more suspect. I doubt they’ll be saving much money since this is year...eight(?). Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.