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posted by martyb on Thursday February 01 2018, @10:22AM   Printer-friendly
from the fixing-what-ails-ya dept.

Amazon Health-Care Move May Be Next 'Home Run' Like Cloud Services

Amazon.com Inc.'s foray into health care won't be the first time it has disrupted an entire industry by starting with an effort inside the company.

Amazon Chief Executive Officer Jeff Bezos is teaming up with fellow billionaires Warren Buffett and Jamie Dimon to revamp health care for the 2.4 million workers and dependents of the companies they run. The move fostered widespread speculation the trio will eventually make their approach to medical care available to companies far and wide.

Bezos has a long, increasingly successful, record of starting new businesses on a small scale, often for the benefit of his company, then spreading them to the masses -- creating a world of pain for incumbents. Consider the ways Amazon is changing industries as varied as product fulfillment, cloud computing and even the sale of cereals, fruits and vegetables.

This is just a cheap excuse to follow up on the machinations of the world's richest human:

Amazon, Berkshire Hathaway, and JPMorgan Chase to Offer Their Own Health Care to U.S. Employees


Original Submission

Related Stories

Amazon, Berkshire Hathaway, and JPMorgan Chase to Offer Their Own Health Care to U.S. Employees 147 comments

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

Amazon, Berkshire Hathaway and JPMorgan Chase announced on Tuesday that they would form an independent health care company to serve their employees in the United States. The three companies provided few details about the new entity, other than saying it would initially focus on technology to provide simplified, high-quality health care for their employees and their families, and at a reasonable cost. They said the initiative, which is in the early planning stages, would be a long-term effort "free from profit-making incentives and constraints."

The partnership brings together three of the country's most influential companies to try to improve a system that other companies have tried and failed to change: Amazon, the largest online retailer in the world; Berkshire Hathaway, the holding company led by the billionaire investor Warren E. Buffett; and JPMorgan Chase, the largest bank in the United States by assets.

Various health insurance and pharmacy companies were hit by the news:

The move sent shares of health-care stocks falling in early trading. Express Scripts Holding Co. and CVS Health Corp., which manage pharmacy benefits, slumped 6.7 percent and 5.5 percent, respectively. Health insurers Cigna Corp. and Anthem Inc. also dropped. The health-care industry has been nervously eyeing the prospect of competition from Amazon for months. While the new company created by Amazon, Berkshire and JPMorgan would be for their U.S. staff only, this is the first big move by Amazon into the industry. The new collaboration could pressure profits for middlemen in the U.S. health-care supply chain.

Related: $54 Billion Anthem-Cigna Health Insurer Merger Rejected by U.S. Judge
CVS Attempting $66 Billion Acquistion of Health Insurer Aetna


Original Submission

Amazon Prime... For Medicaid Recipients 79 comments

Amazon launches a low-cost version of Prime for Medicaid recipients

Amazon announced this morning it will offer a low-cost version of its Prime membership program to qualifying recipients of Medicaid. The program will bring the cost of Prime down from the usual $10.99 per month to about half that, at $5.99 per month, while still offering the full range of Prime perks, including free, two-day shipping on millions of products, Prime Video, Prime Music, Prime Photos, Prime Reading, Prime Now, Audible Channels, and more.

The new program is an expansion on Amazon's discounted Prime service for customers on government assistance, launched in June 2017. For the same price of $5.99 per month, Amazon offers Prime memberships to any U.S. customer with a valid EBT card – the card that's used to disburse funds for assistance programs like Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), and Women, Infants, and Children Nutrition Program (WIC).

It could be a way to get users with certain health care requirements on board before Amazon launches its own health insurance company.

Also at USA Today.


Original Submission

Walmart Could Jump on the "Buy a Health Insurer" Trend with Humana Acquisition 25 comments

Walmart could acquire the health insurer Humana, in a deal reminiscent of CVS's acquisition of Aetna:

Walmart Inc. is in preliminary talks to buy insurer Humana Inc., according to people familiar with the matter, a deal that would mark a dramatic shift for the retail behemoth and the latest in a recent flurry of big deals in health-care services.

It isn't clear what terms the companies may be discussing, and there is no guarantee they will strike a deal. If they do, the deal would be big: Humana currently has a market value of about $37 billion. It also would be Walmart's largest deal by far, eclipsing its 1999 acquisition of the U.K.'s Asda Group PLC for $10.8 billion. Walmart, which in addition to being the world's biggest retailer is also a major drugstore operator, has a market value of about $260 billion.

[...] Walmart has a vast pharmacy business, with locations in most of its roughly 4,700 U.S. stores and in many of it Sam's Club warehouse locations. Humana is a Medicare-focused insurer that could deepen Walmart's relationship with a key demographic—seniors—at a time when the retailer is being threatened by Amazon on several fronts.

Also at CNN.

Related: $54 Billion Anthem-Cigna Health Insurer Merger Rejected by U.S. Judge
CVS Attempting $66 Billion Acquisition of Health Insurer Aetna
Amazon, Berkshire Hathaway, and JPMorgan Chase to Offer Their Own Health Care to U.S. Employees
Is Amazon Planning a Disruptive AWS-Like Move Into Health Care?
Amazon Prime... For Medicaid Recipients


Original Submission

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  • (Score: 4, Insightful) by AlphaSnail on Thursday February 01 2018, @10:56AM (8 children)

    by AlphaSnail (5814) on Thursday February 01 2018, @10:56AM (#631416)

    Nobody wants to trust him, but... how the hell is the healthcare industry supposed to become streamlined reducing costs and redundancy without someone starting over from scratch? It's not coming from within the industry as is ever - nobody is really in charge of this mess its decades of compromises, mistakes, middlemen, drug company profiteering, legacy contracts, regulations that may or may not in all cases be necessary - who is going to sort all that out, find the waste and get people to stop participating in it with any authority? People are getting paid by this system and they aren't just going to own up to it and start applying at McDonalds, everyone is going to argue for their continued relevance and nobody can fix this unless that person were somehow in charge of the whole show since even from a transparency perspective we can't see what the real cost of anything is. If the Amazon machine can start their own system and get it running in house and export it and it can compete with the rest of the industry it can only be a good thing so either it fails and something is learned or we all get the benefit so I say good luck to them.

    • (Score: 2, Redundant) by bradley13 on Thursday February 01 2018, @01:07PM (5 children)

      by bradley13 (3053) on Thursday February 01 2018, @01:07PM (#631454) Homepage Journal

      As long as any new health care provider is subject to all the same governmental regulations, they will have the same impossible cost-control problems. These, in the end, are driven by the crying need for life to be fair. Life isn't fair.

      If you talk to someone who's a fan of government run health care, they are always fighting against a "two-class healthcare system". I have news for them: There will always be a two-class system. Warren Buffet can afford better health care than you can, and you can afford better health care than the homeless dude under the bridge. Life's a bitch; denying reality isn't going to change that.

      Want the government to provide a minimum level of health care for the indigent? Fine, but do so separately from the insurance market used by ordinary folk. Trying to combine the two is a disaster.

      Then let the health insurance market be an insurance market. If you have a pre-existing condition, you're going to have a problem. See "health care for the indigent" above - that's likely you, because you will never qualify for insurance.

      Those people who want to take a gamble and go uninsured? Their privilege, but if they get sick or injured, they'll need to pay cash. Or see "health care for the indigent" above.

      The vast majority of working people will have insurance policies. They can sign up for a long-term policy, just like people do for life insurance. Sign up while you're young and healthy, and the costs will be a tiny fraction of today's insane prices. These should be individual policies - not tied to the workplace - because they are for your individual health. If your employer wants to pay the premiums great, but it's still your policy.

      FWIW, what I describe is pretty much what we had in Switzerland until about 20 years ago. Worked great. Then the progs got all up-in-arms about fairness, and we now have our own miniature version of Obamacare: a free market that isn't. My premiums doubled overnight at the time, and have gone up massively every year since. The health minister wrings his hands on TV - he just doesn't understand why prices don't magically sink, even as he keeps piling on more and more regulations to try and cancel out the effects of the last round of additional regulations.

      --
      Everyone is somebody else's weirdo.
      • (Score: 2) by opinionated_science on Thursday February 01 2018, @01:45PM (4 children)

        by opinionated_science (4031) on Thursday February 01 2018, @01:45PM (#631465)

        it is impossible to have a free market for a product, that if not delivered, can have your pain or mortality used against you.

        It is no accident, I have never met a poor physician in *any* country....

        • (Score: 3, Touché) by Justin Case on Thursday February 01 2018, @02:17PM (3 children)

          by Justin Case (4239) on Thursday February 01 2018, @02:17PM (#631477) Journal

          You mean like food?

          • (Score: 2) by julian on Thursday February 01 2018, @04:47PM (1 child)

            by julian (6003) Subscriber Badge on Thursday February 01 2018, @04:47PM (#631528)

            You think food is a free market? Ever heard of farm subsidies? Food stamps? Not to mention the fact that we've essentially reached post-scarcity with food; most people are threatened by an overabundance of calories rather than a lack of them.

            • (Score: 3, Interesting) by Justin Case on Thursday February 01 2018, @05:07PM

              by Justin Case (4239) on Thursday February 01 2018, @05:07PM (#631548) Journal

              Well I'm not an advocate of government interference in the food market, like what you describe, but then government gets its tentacles into everything so really there aren't any free markets in anything.

              But I was pointing out that it is possible to buy food at less than your-money-or-your-life prices because:

              * You are the one paying the cost, so you are motivated to shop around. This keeps prices down.

              * You are the one making the choice, fully informed of the price at the time you choose.

              * You have a choice of "food care providers". Not a one-size-fits-all heavily-regulated choice-eliminating "food insurance plan".

          • (Score: 2) by opinionated_science on Saturday February 03 2018, @03:43PM

            by opinionated_science (4031) on Saturday February 03 2018, @03:43PM (#632552)

            food occurs naturally in this world and humans can feed themselves - usually.

            Healthcare, not so much....

    • (Score: 2) by stretch611 on Thursday February 01 2018, @05:36PM (1 child)

      by stretch611 (6199) on Thursday February 01 2018, @05:36PM (#631572)

      I hate Amazon... It has become the Walmart of the online world.

      However, I hope they succeed. I hope they completely destroy the insurance companies. I hope they streamline the process completely.

      Of course, once they do, I hope others learn how to recreate the streamlined process and bring real competition and cost savings into the area.

      --
      Now with 5 covid vaccine shots/boosters altering my DNA :P
      • (Score: 0) by Anonymous Coward on Friday February 02 2018, @12:15AM

        by Anonymous Coward on Friday February 02 2018, @12:15AM (#631783)

        First, as super_bob notes down in the (meta)thread, this story is a dup.
        ...and not the only one today. 8-(

        I hope they streamline the process

        Wishful thinking, I'm afraid.
        As isostatic notes just below us, this is a company store thing.
        Where single-payer universal coverage for all would make it so that changing jobs would not incur a period of non-coverage (paper-shuffling period; enrollment windows; employee probation period with new employer), this thing will tend to bond a worker to an employer--probably even more tightly than other health insurance models.

        This appears to be a return to Feudalism.

        Now, if this thing was opened up the way that happened with Henry Kaiser's Kaiser-Permanente (mentioned in the previous story), -that- would be interesting.

        -- OriginalOwner_ [soylentnews.org]

  • (Score: 4, Insightful) by isostatic on Thursday February 01 2018, @11:06AM

    by isostatic (365) on Thursday February 01 2018, @11:06AM (#631418) Journal

    You load sixteen containers, what do you get
    Another day older and deeper in debt
    Saint Peter don't you call me 'cause I can't go
    I owe my soul to the company store

  • (Score: 2) by LoRdTAW on Thursday February 01 2018, @01:00PM (5 children)

    by LoRdTAW (3755) on Thursday February 01 2018, @01:00PM (#631451) Journal

    I predicted this in an older article where I questioned where mega corps like Amazon would draw the line at trying to become a sci-fi style omnicorp where a single giga corp provides all or most of the services to an oppressed future population.

    • (Score: 4, Insightful) by JoeMerchant on Thursday February 01 2018, @02:37PM

      by JoeMerchant (3937) on Thursday February 01 2018, @02:37PM (#631485)

      Forget the dystopia... what's the Billionaire's dilemma? They've got so much money that any time they shift it around it moves the markets and thwarts any efforts at significant growth through investment - Buffet has written about this many times. So, what's a good scam, ahem, industry that you can make big ROI with your billions? Insurance. Buffet already has GEICO, but healthcare is the next rung up the ladder.

      --
      🌻🌻 [google.com]
    • (Score: 0) by Anonymous Coward on Thursday February 01 2018, @06:06PM

      by Anonymous Coward on Thursday February 01 2018, @06:06PM (#631594)

      I think your crystal ball was pointing in the wrong direction when you made that prediction :)

      "where mega corps like Amazon would draw the line at trying to become a 19th-century style omnicorp where a single giga corp provides all or most of the services to an oppressed past population."

      Everything old is new again, etc.

    • (Score: 0) by Anonymous Coward on Thursday February 01 2018, @10:35PM (2 children)

      by Anonymous Coward on Thursday February 01 2018, @10:35PM (#631734)

      I predict in 50 years we will be looking at Amazon as a dying company. https://www.smithsonianmag.com/history/rise-and-fall-sears-180964181/ [smithsonianmag.com]

      They are following in their footsteps almost exactly. For my next act of prestidigitation I predict they buy large swaths of mall space and become mega stores.

      • (Score: 2) by Eristone on Thursday February 01 2018, @11:00PM

        by Eristone (4775) on Thursday February 01 2018, @11:00PM (#631744)

        Frankly, Sears should be where Amazon is today. They already had the infrastructure to move just about everything to your doorstep or local catalog center for pickup. What they didn't have was management that could grasp the Internet and online sales. Had someone took the Christmas catalog, put it online, set up a way for payment and layaway and marketed it, they could have brought Amazon out and just made books a division of the catalog.

      • (Score: 2) by JoeMerchant on Friday February 02 2018, @01:10AM

        by JoeMerchant (3937) on Friday February 02 2018, @01:10AM (#631811)

        predict they buy large swaths of mall space and become mega stores.

        They seem to be cutting closer to the bone, with grocery.

        --
        🌻🌻 [google.com]
  • (Score: 2, Insightful) by VLM on Thursday February 01 2018, @01:22PM (1 child)

    by VLM (445) Subscriber Badge on Thursday February 01 2018, @01:22PM (#631460)

    Somehow I don't see amazon customer service bots providing mental health services or anyone wanting their OBGYN visit uploaded to a cloud for outsourced Indian doctor interpretation.

    I could see this being a smoke cloud for the deployment of the worlds ultimate prescription pharmacy service. Sometimes the local Walgreens is out of stuff or it takes a day or two. Not really Amazon-like. Also Amazon is great with cross promotion, so now Amazon Prime comes with free Prozac and every pr0n DVD comes with some ED drugs. Amazon is pretty good with billing whereas walgreens is very much roll the dice and see what we demand for payment, free, $900, who knows until you roll up.

    • (Score: 0) by Anonymous Coward on Friday February 02 2018, @01:27AM

      by Anonymous Coward on Friday February 02 2018, @01:27AM (#631819)

      Amazon Health Bot: "You have dysplasia."
      Patient: "I have what?"
      Amazon Health Bot: "Other patients who had dysplasia also had carcinoma."
      Patient: "Other ... what?"
      Amazon Health Bot: "Would you like to add carcinoma to your cart?"
      Patient: "Don't you mean chart?"
      Amazon Health Bot: "Would you like to try a free month of Amazon Prime Healthcare?"

  • (Score: 0, Troll) by Anonymous Coward on Thursday February 01 2018, @01:34PM (3 children)

    by Anonymous Coward on Thursday February 01 2018, @01:34PM (#631462)

    The real problem is that american healthcare is way too expensive. Drugs cost hundreds of times what they cost elsewhere. And then the healthcare terrorism: get a prescription for headache medicine (translation: pay a jew rat big money so he will agree to write a note for you on a piece of paper).

    Sick minds came up with the healthcare system the U.S has. Anyone wanting to keep people healthy would not burn money on spin-"doctors" and instead drag those who destroyed the system into the street and hang them publicly.

    • (Score: 0) by Anonymous Coward on Friday February 02 2018, @12:33AM (2 children)

      by Anonymous Coward on Friday February 02 2018, @12:33AM (#631790)

      Drugs cost hundreds of times what they cost elsewhere

      Extreme hyperbole.
      You're gonna have a hard time coming up with a cite for that one.

      Sick minds came up with the healthcare system the U.S has

      Amen.

      a jew rat

      Purposely flirting with the folks who like to hand out SPAM mods?
      It's sad that you have allowed your mind to be poisoned with bigoted scapegoating.
      In some areas, you demonstrate clear thinking.

      ...and to straighten you out, the problem here is the Capitalist economic model.

      As an example, Cuba has a very socialized healthcare model and gets excellent results for a tiny fraction of what USA spends.
      Bolivia also has a very socialized healthcare model and has partnered with Cuba in training its medical students as well as exchanging goods for trained doctors in the meantime.
      That's working well for both countries.

      -- OriginalOwner_ [soylentnews.org]

      • (Score: 2) by choose another one on Friday February 02 2018, @09:57AM (1 child)

        by choose another one (515) Subscriber Badge on Friday February 02 2018, @09:57AM (#631934)

        Drugs cost hundreds of times what they cost elsewhere

        Extreme hyperbole.
        You're gonna have a hard time coming up with a cite for that one.

        Well I'm not - OTOH, Daraprim. Big news at the time - $750 in the US from one monopoly supplier, 5 to 10 cents in India from multiple generics suppliers.

        Cite: https://www.clinicalleader.com/doc/high-drug-prices-should-we-blame-pharma-or-the-fda-0001 [clinicalleader.com]

        Although the increase in Daraprim from $13.50 to $750 caused an understandable uproar, everyone fails to recognize a more subtle discrepancy: prior to the increase, that same drug that was selling for $13.50 in the U.S. was selling for between five and 10 cents in India.

        • (Score: 0) by Anonymous Coward on Friday February 02 2018, @01:51PM

          by Anonymous Coward on Friday February 02 2018, @01:51PM (#631987)

          So, to be clear, your arithmetic skills are terrible, your calculator is broken, and your dictionary doesn't contain "hyperbole".
          "Hundreds of times" would be a minimum of $2700. [google.com]

          -- OriginalOwner_ [soylentnews.org]

  • (Score: 5, Insightful) by Justin Case on Thursday February 01 2018, @02:24PM (11 children)

    by Justin Case (4239) on Thursday February 01 2018, @02:24PM (#631479) Journal

    I try very hard, before engaging any medical service (including prescriptions), to ask

    What is this going to cost?

    It is very hard to get an answer. Even when you do, it is probably wrong by several orders of magnitude. And then somehow I am supposedly obligated to pay an amount to which I never agreed.

    This has to be fixed. How can you shop around for reasonable prices when everything is $Random[$Today]?

    • (Score: 1, Insightful) by Anonymous Coward on Thursday February 01 2018, @02:47PM (1 child)

      by Anonymous Coward on Thursday February 01 2018, @02:47PM (#631486)

      I've gotten "we won't know how much it costs until we bill you" on multiple occasions. In what world is this a legitimate business model?

      • (Score: 2) by stretch611 on Thursday February 01 2018, @05:31PM

        by stretch611 (6199) on Thursday February 01 2018, @05:31PM (#631568)

        You are absolutely right.

        However, despite not being able to give an accurate estimate, their computer is able to determine how much you owe as you are walking out of the office.

        The only time this is not accurate is when the insurance company decides not to pay for everything because something is flagged as not covered. (and 90% of those times it is covered but you have to go through the insurance companies appeal process which is only designed only to delay your actual benefits until you give up being on the phone for hours.)

        --
        Now with 5 covid vaccine shots/boosters altering my DNA :P
    • (Score: 5, Informative) by bradley13 on Thursday February 01 2018, @03:42PM (2 children)

      by bradley13 (3053) on Thursday February 01 2018, @03:42PM (#631499) Homepage Journal

      I assume you are in the US? I have a friend in the US, whose wife went to an "in network" hospital for treatment. Ought to be fine, right? In the course of things, various random doctors came in, looked at her chart, often said nothing at all, and left. When she gets out, her bill had separate entries for lots of those doctors: "consultation, not in network", "consultation, not in network". WTF?

      I hope he has the balls to take the hospital to court. Either they are "in network" and in control of who wanders their corridors, or they aren't. Either way, it shouldn't be my friend's problem. And random consults just to chalk up another billable hour? Ought to get the both the physicians and the hospital sanctioned.

      --
      Everyone is somebody else's weirdo.
      • (Score: 3, Interesting) by Justin Case on Thursday February 01 2018, @03:55PM (1 child)

        by Justin Case (4239) on Thursday February 01 2018, @03:55PM (#631507) Journal

        Yeah, that "in network" bullshit is one of the scams. "In network" doctor sends out some lab work. Lab is not "in network" => $ZAPPIE. Or if you choose the lab yourself, they send one of the tests to a "partner". If you ask the desk clerk "are you going to do this work in house or send it out" she gives a blank doe eyed stare that makes it clear she doesn't know and couldn't possibly care. "Check our web site." Web site says nothing. Send message to "customer service". No reply.

        Then, those not-in-network charges are 10 to 100 times the real price the same places are willing to accept from insurance.

        I'm about to the point of letting them take me to court, where I'll simply ask "show me the contract I signed agreeing to this price". Except, you know, binding arbitration clause in the EULA and stuff like that. Still, make them fight for it.

        One company even used my stored credit card number (they promised not to store it -- haha) to fetch some extra cash out of my account. Must be nice. Want more dollars? Just grab them. Anytime is fine. As much as you want. Help yourself, no problem.

        Canceled my card, disputed the charge... waiting to see whose side my bank takes. Any guesses???

        • (Score: 2) by Justin Case on Thursday February 01 2018, @04:08PM

          by Justin Case (4239) on Thursday February 01 2018, @04:08PM (#631515) Journal

          #include SelfReplyApology

          I just remembered their new trick this year: Tier One providers. You can save a lot of money by choosing only Tier One from the list on our website.

          No, you don't save a damn nickel. What this really means is they will charge you double for any provider who is not "Tier One".

          So you check the website when you make your appointment. Great, Tier One. You go there and get charged double anyway. "Yeah we're not Tier One any more." But you were last week? "Perhaps someone forgot to update the website." OK, so how is that my problem?

          I have altered the bargain. Pray I do not alter it further. Now, just sign all these consent forms and I'll get my knives and go to work.

    • (Score: 5, Insightful) by julian on Thursday February 01 2018, @04:41PM

      by julian (6003) Subscriber Badge on Thursday February 01 2018, @04:41PM (#631522)

      How can you shop around for reasonable prices when...

      When you're incapacitated? Delirious with fever? Gut shot? Oh and even if you are of sound mind at the time, you're not a doctor, and thus are ignorant of medicine and treatments anyway. So how can you shop around *when you don't even know what you're shopping for?*

      You cannot run health care with markets efficiently OR fairly. It doesn't work; there's too much asymmetry between sellers and buyers in knowledge and negotiating leverage for it to ever be either efficient or fair. It's absolutely the wrong tool for the job but when you're a conservative that's all you've got in your tool box.

    • (Score: 4, Interesting) by NotSanguine on Thursday February 01 2018, @05:25PM (1 child)

      by NotSanguine (285) <NotSanguineNO@SPAMSoylentNews.Org> on Thursday February 01 2018, @05:25PM (#631564) Homepage Journal

      I try very hard, before engaging any medical service (including prescriptions), to ask

      What is this going to cost?

      It is very hard to get an answer. Even when you do, it is probably wrong by several orders of magnitude. And then somehow I am supposedly obligated to pay an amount to which I never agreed.

      This has to be fixed. How can you shop around for reasonable prices when everything is $Random[$Today]?

      I disagree in one respect. The "prices" aren't necessarily random, they're massively inflated, and there may well be some method to that inflation.

      The issue, as far as I can tell, is that "prices" are set for the uninsured, especially those who have cold, hard, cash. Those "prices" have nothing to do with costs or reimbursements.

      Case in point: About ten years ago I was briefly (three days) hospitalized and given strong IV antibiotics "just in case" I had MRSA [wikipedia.org] which, it turned out, I didn't have.

      I received (as insurance companies generally do) a "detailed" explanation of benefits (EOB) for my hospital stay. it came out to be somewhere around US$14,000.00.

      However, the EOB contained a number of grievous inaccuracies, of which the most ridiculous were:
      I was, apparently, in two hospital rooms at the same time -- which would be a great trick, except I'm not entangled photons.
      I also, apparently, had a Pap Smear [wikipedia.org], which is even more amazing, since, as a male, I have no cervix.

      I called the hospital billing folks to find out what the story was with all this and was told, essentially, not to worry about it, as I wasn't paying anyway.

      I protested, as even in 2008 (long before the ACA came into effect), premiums, co-pays and and other costs had been rising steadily, much faster than inflation, for decades. Not because I had to bear the full "cost," but because it certainly seemed that there was significant and blatant fraud on the part of the hospital, with apparent acquiescence by the insurance company.

      Finally, after going back and forth with the hospital for a day or two, the billing folks at the hospital got me on a conference call with the payment folks at the insurance company.

      They went back and forth, talking in jargon, and when I demanded to know what the real story was, the hospital and insurance company admitted that the EOB was irrelevant to their billing and payment, as the hospital's contract with the insurer mandated a US$1500.00/day reimbursement to the hospital, regardless of the actual services provided.

      So, if you have insurance, the "prices" aren't real, and the "costs" aren't real. If you don't have insurance, then you are smacked with hugely inflated "prices" that (obviously) bear no relation to the actual costs of care.

      I never did receive the pathology report on my pap smear. Fortunately, I'm pretty sure I don't have cervical cancer -- not having a cervix and all.

      --
      No, no, you're not thinking; you're just being logical. --Niels Bohr
      • (Score: 2) by darkfeline on Friday February 02 2018, @04:42AM

        by darkfeline (1030) on Friday February 02 2018, @04:42AM (#631883) Homepage

        I suspect medical billing codes are just a very complicated mechanism for tallying up a bill.

        Say the hospital wants $10,000 for your visit. They open up your insurance's billing catalog and go down the list.

        "Let's take the dolphin bite for $1,000, two saline bags and an HIV drug for $6,500, skin rash for $1,500, and oh, let's see, the prostate exam for $2,000. How much is that? $9,500? Fuck, what's $500? Let's use this blood test."

        --
        Join the SDF Public Access UNIX System today!
    • (Score: 2) by All Your Lawn Are Belong To Us on Thursday February 01 2018, @08:22PM (2 children)

      by All Your Lawn Are Belong To Us (6553) on Thursday February 01 2018, @08:22PM (#631661) Journal

      How can you get a reasonable price until you've been examined and the examiner has some inkling clue of what is actually wrong with you?

      The reason you can't pin most physician offices down is because the office will charge based on the overall level of complexity of your visit. Take 5 minutes of the Doctor's time who then advises you to wait or hands you a simple prescription. low rate. Have ten co-morbidities and take up a half hour of the physicians' time who ultimately orders further diagnostic testing to make sure you're getting an effective treatment before he/she offers it... much higher rate. Spend fifteen minutes of the physican's time who decides you need to go to the ER and he then follows up with you in the hospital that afternoon.... still different rate.

      You're asking for a fix for your body. The price will depend on just what the problem is, just like any other mechanism that breaks down and you need a repairman for.

      That's already changing a little bit as things in healthcare shift from fee-for-service to value-based healthcare. But could the industry offer you a flat estimate rate? You pay X dollars until we either find out what's wrong with you or your problem takes longer than what it is? OK.

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      • (Score: 2) by choose another one on Friday February 02 2018, @09:42AM (1 child)

        by choose another one (515) Subscriber Badge on Friday February 02 2018, @09:42AM (#631931)

        How can you get a reasonable price until you've been examined and the examiner has some inkling clue of what is actually wrong with you?
        [...]
        You're asking for a fix for your body. The price will depend on just what the problem is, just like any other mechanism that breaks down and you need a repairman for.

        This.

        Call a plumber and say "my toilet won't flush, how much to fix it?".

        Call an electrician and say "my electrics gone off, how much to fix it?".

        Call a mechanic and say "my car's stopped, how much to fix it?".

        Same answer each time (after the laughter) - $x callout, $y per hour, plus parts, if it can be fixed.

        But it's worse in medical, because even when they _think_ they know what's wrong and maybe how to fix it, there's still other stuff that can go wrong during the fixing that needs to be fixed too. This isn't stuff that goes wrong because the doctor or the hospital does something wrong, it's just the fact that we still know very little about how the body works and each and every body is different, and reacts differently. It's luck (or lack of) and being on the wrong side of the statistics (if someone tells you "this drug cures 90% of people with your condition with no side effects" the most important thing to ask is actually "what happens to the 10%").

        If you go in for an operation and they say it should be 2 days recovery on the ward, but your body happens to react to the suture material leading to wound breakdown, bleeding, emergency re-op, crash, 5 days intensive care, etc., then what the hell _should_ the bill be?

        "Hold the crash cart, we need to check if we quoted for a de-fib". Really?

        • (Score: 2) by All Your Lawn Are Belong To Us on Friday February 02 2018, @01:47PM

          by All Your Lawn Are Belong To Us (6553) on Friday February 02 2018, @01:47PM (#631985) Journal

          Plumbers, electricians, and mechanics generally don't have an insurance system which requires submission of discrete codes to categorize their work. They generally do not have to order diagnostic tests that others will perform for any given episode of care.

          If they themselves deal with insurance at all (not likely, by the way, except for auto mechanics,) they price out an estimate and ship that complete estimate off. They don't get to tell the insurance company, "yeah, we'll charge somewhere between 3 and 5 hours to fix that plus $200." Auto mechanics, like physicians, have to tell the insurance companies exactly how much the bill will be before work commences.

          It's relevant because your outpatient physician has a series of discrete codes they charge. For nominal office visits there are five levels of visit that can be charged. There are lots of rules of thumb about it, but it's basically what I said above - how much work will the physician (and other staff) go through for the care episode. All of this is necessary because of insurance. Doctors would LEAP at the chance to charge you a Level 5 visit every time, instead of having other people look at the work they did and assign a relative value. That won't happen, because the insurance companies won't let it.

          Every repair industry has a process for what happens if other things go wrong and beyond their estimate of what's up. But it goes beyond just "we don't know how the body works entirely." It also works off the principal of doing the least amount of work *on average* to cure a given set of symptoms. You come in with an infection. The physician looks at it, checks temp and other vital signs, and makes a best estimate of your condition. He *could* order a culture to be taken (that has happened to me,) but most of the time he knows if he prescribes Antibiotic X (or gram postitive/negative combination antibiotics X+Y) his patient will get better 90% of the time.... or he suspects you may just have a virus infection and decides to not prescribe anything but OTC symptom control because he doesn't want to be wrong with the bacteria and make the possibility of creating a resistant strain. He doesn't order the culture because knowing exactly which organism it is very rarely affects the course of treatment.... the times when it does, he orders the test. Now if he'd ordered that test, he'd could definitively what he should do (though that may take hours to days to get a result)..... but then he's accused of ordering "unnecessary" tests. High quality, low cost healthcare is a game of average, not specific cases... which really sucks if you're the individual patient but few people care about that. Your doc could test if you'd be a candidate for a particular side effect, maybe, but again he won't unless that side effect is a fatal condition occurring in enough cases to be a problem.

          So.... what the hell should the bill be IF you have that situation. Hospital billing is ENTIRELY DIFFERENT. Instead of charging on the services performed, a hospital will take the sum total of your diagnoses, issue a diagnosis-related Group code and bill based off that complex. "Aha!" you think - that's the ticket! But remember that we need to know your final diagnosis before that code is settled upon. Come in with a hangnail for observation... actually you'll get billed by the outpatient rules because reasons.... but once you're in the hospital unless you leave against medical advice you're going to be diagnosed as accurately as possible because the hospital will ultimately be paid based on what you actually had happen. Which is why hospitals have in-house labs and diagnostic services and all that. And if your condition worsens.... your diagnosis changes. Surgery is a little different because your surgeon will be their services as outpatient services (I did X, pay me for what I did) while the hospital still bills the diagnosis complex for their care.

          Because of this, no they won't check if they quoted for a cardiac arrest. Come in with an infarction (or develop one) and your diagnosis codes change to handling the code. All the labor, materials, etc. are covered. And you pay a HELL of a lot more than if it happened at your Doctor's office, the medics come, and you're pronounced at the scene.

          So, do you want the current system where it feels like you're being screwed, or do you want a system that doesn't operate on averages and you pay some multiple of that more? Because medicine ain't plumbing, or car repair, or electrical, and any system where you'd be paying flat quotes would drive the price up, not down.

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  • (Score: 2) by bob_super on Thursday February 01 2018, @05:16PM (3 children)

    by bob_super (1357) on Thursday February 01 2018, @05:16PM (#631555)

    https://soylentnews.org/article.pl?sid=18/01/30/171224 [soylentnews.org]

    Twice in a week. Has TMB been whipping editors so hard they don't get sleep ?

    • (Score: 2, Disagree) by takyon on Thursday February 01 2018, @07:02PM (2 children)

      by takyon (881) <reversethis-{gro ... s} {ta} {noykat}> on Thursday February 01 2018, @07:02PM (#631621) Journal

      Not a dupe, everything addressed right there in the summary.

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      [SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
      • (Score: 2) by bob_super on Thursday February 01 2018, @07:10PM

        by bob_super (1357) on Thursday February 01 2018, @07:10PM (#631624)

        How is this one not a simple speculation based on the information already contained in the previous one ?

      • (Score: 2) by All Your Lawn Are Belong To Us on Thursday February 01 2018, @08:16PM

        by All Your Lawn Are Belong To Us (6553) on Thursday February 01 2018, @08:16PM (#631657) Journal

        Exactly a dupe. Amazon, Berkshire, and JPMorgan are offering their own healthcare program to their employees. That's what TFA here is saying with added frisson of "Look, it's Billionaires and IT MAY BECOME PUBLICLY ACCESSIBLE SOMEDAY JUST LIKE AWS!!!" Based on Absolute Speculation that has No Factual Basis Whatsoever that they'll ever go public with it! But it's exactly the same story.

        But it's on the Internet, so I guess that's OK.

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