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Amazon, Buffett, JPMorgan Team Up on Healthcare: Hot Air or Real Deal?

Three high-power firms agreed to take on rising healthcare costs. Sceptics abound. Can they succeed where others failed?

Three corporate behemoths — Amazon, Berkshire Hathaway and JPMorgan Chase — announced on Tuesday that they would form an independent health care company for their employees in the United States.

It was unclear how extensively the three partners would overhaul their employees’ existing health coverage — whether they would simply help workers find a local doctor, steer employees to online medical advice or use their muscle to negotiate lower prices for drugs and procedures.

Details are scant but hopes are high in this joint BusinessWire Statement.

Three Statements

  • Warren Buffett: “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. Rather, we share the belief that putting our collective resources behind the country’s best talent can, in time, check the rise in health costs while concurrently enhancing patient satisfaction and outcomes.”
  • Jeff Bezos: “The healthcare system is complex, and we enter into this challenge open-eyed about the degree of difficulty,” said Jeff Bezos, Amazon founder and CEO. “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.”
  • Jamie Dimon: “Our people want transparency, knowledge and control when it comes to managing their healthcare.The three of our companies have extraordinary resources, and our goal is to create solutions that benefit our U.S. employees, their families and, potentially, all Americans”

Details Scant, Sceptics Abound

CNBC says this is a Lot Tougher Than It Looks.

  • Evercore health-care analyst Ross Muken: "Bending the overall health-cost curve isn't about controlling drug prices, modernizing the supply chain or improving devices. Those are all relatively small parts of spending and some of those parts are deflationary already. This is about getting to the guts of the system and where the inefficiency lies, which is physicians and hospitals. A majority of the costs in the system sit within organizations that are difficult to reform. Furthermore, trying to tackle physician compensation also seems like a heroic effort and one that is likely to cause massive uproar, particularly amongst the senior population."
  • Mickey Chadha, a vice president at Moody's: The new joint venture "could be disruptive" and put competitive pressure on pharmacy giants CVS and Walgreens and pharmacy benefit managers, but the regulatory burden around every aspect of health care puts "any new entrant in the space at a huge disadvantage. Companies like CVS, Walgreens, United Healthcare, Aetna and Express Scripts already have large scale, which allows for better vendor and drug manufacturer contracting and the ability to serve national clients."
  • Gary Claxton, vice president of the Kaiser Family Foundation, said the biggest driver of health costs is the money spent on sick and very sick people. "It's not clear what private payers can do" to drive down those costs, Claxton said, referring to insurance plans such as those offered by Amazon, Berkshire Hathaway, J.P. Morgan Chase and other businesses, as opposed to large publicly provided health coverage systems such as Medicare and Medicaid.

Tough or Impossible?

Gary Claxton nails the largest problem: "The biggest driver of health costs is the money spent on sick and very sick people."

Right to Die

Does your policy cover lung cancer? Why should it have to?

But if it doesn't, why are you entitled to treatment?

I am a strong believer in the right to die. Spending hundreds of thousands of dollars to keep someone alive for an extra few months is absurd.

Lack of Choices

Obamacare mandated Gold, Silver, and Bronze options. I propose letting insurers offer whatever plans they want.

Basic coverage might cover emergencies, but not long-term cancer treatments.

The marketplace, not government bureaucrats should come up with plans and pricing. Let people pick the options they want.

Mish Health Care Proposals

Published fees: Fees for routine services, medicine, and operations need to be published, not set by government mandate. Whether or not someone is insured, the fees should be the same.

Shopping Around: People should be encouraged to shop around for the lowest-cost provider. Insurers can help. Want to go somewhere else? If your policy covers what you seek, fine. If not, you pay extra.

Foreign Services: Bloomberg reported Heart Surgery in India for $1,583 Costs $106,385 in U.S. Demand treatment in the US? Fine. You should have to pay for it with higher premiums. It's a free choice. Obviously, this provision does not apply to emergency services like an accident or a heart attack.

Drug Pricing: Allow imports of drugs to increase competition. Medicaid and Medicare should buy in bulk from the lowest cost provider.

Right to Die: No one should be kept alive if they want to die. Nor should someone be artificially kept alive if they do not have insurance, or their spouse or designated appointee wants to pull the plug on their behalf.

Right to Refuse Service: If someone is not insured, hospitals should have the right to refuse service.

Medicare/Medicaid: Currently, those over 65 do not care what things cost. Incentives are necessary to make sure they do. This includes forcing overseas treatment for those able to travel. Once again, spending hundreds of thousands of dollars to keep someone alive for an extra few months is beyond absurd. Medicare should be no different on foreign care or shopping around.

Patent Restrictions: Patent laws need to be revised to prohibit making minor changes and renewing patents for extended periods again and again.

Eliminate State Restrictions: Allow any insurance company in any state sell insurance in whatever states they want.

Bezos Factor

My proposals provide significant cost savings opportunities forced on drug providers, allowed by hospitals, and allowed by insurers, at a huge benefit to insureds.

Some of my proposals require significant changes to Obamacare. So what?

With Buffett, Bezos, and Dimon on board, such changes are not impossible.

I do not dismiss anything out of hand when Jeff Bezos and Amazon are involved.

Mike "Mish" Shedlock

And I would guess that if you polled the residents of those three countries if they would trade their health care system for the one in the US, that the result would be 99% saying no.

@realist Out of curiosity, where did you get those numbers? Sorry, probably easy to find, but figure you have the URL in your browser cache. Thanks. ... ... Well, again, if the US .gov site is correct in saying half of US spending is on Medicare/Medicaid/VA (the US's single payer system)and these numbers you found are correct, then it seems the US has a broken single payer system. Very broken. Which goes against the narrative of how Medicare is very cost efficient. I get skeptical when the same people assert conflicting information. (Note: Medicare's affect on the US medical "system" goes well beyond what they spend and the patients they spend it on. But that's another story.)

Oh. Yep, I'd guess the same thing about poll results.

Hi Felix. The numbers were from Wikipedia. List of health expenditures by country. There was a list from the OECD and another from WHO. Both were similar. Please note; there is no perfect health system. They can all be improved. There will always be complaints from users. I’m just saying that given how expensive and messed up the current system is in the US, that the BBD initiative is perhaps the first step in creating an efficient, modern health system. I wish them well with it. And I hope it becomes the model for others in the world to follow.

Large companies are going self insured and sending their employees out of country for routine procedures, saving money, with better clinical outcomes. The U.S. health care industry now ranked about 38th among industrialized nations, also touts iatrogenic disease (death by doctor) as our third leading cause of death, and the most expensive health care in the world. For every doctor we've got 10 administrators. It's no secret, if you want to live, you make sure you have a doctor outside the U.S. that you can go see fairly quickly. Here they'll just let sepsis or bacterial infections take you. To much liability now in U.S. health care, the doctors are better off refusing to acknowledge your symptoms, unless your bleeding, have pus sacks, or a blood infection your good. If you've got cancer they'll diagnose that later as well, it's cheaper to diagnose in it's latest stages, and more profitable with lots of cutting. They don't do much outside of cutting and prescribing.

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