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.
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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
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.
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Is Amazon Planning a Disruptive AWS-Like Move Into Health Care?
Amazon Prime... For Medicaid Recipients
Amazon has reported that it has reached 100 million Prime subscribers worldwide:
The big numerical reveal on Wednesday was Amazon.com Inc. finally spilling the beans on the number of Prime members (more than 100 million). It also disclosed another number that shows how much it relies on an army of people moving physical merchandise around the world: $28,446.
That's the median annual compensation of Amazon employees. Amazon reported this number for the first time under a new requirement that companies disclose the gap between pay for the rank-and-file and the person in the corner office. (Amazon Chief Executive Officer Jeff Bezos, the world's richest person, reported total compensation of $1.68 million last year. As in prior years, he didn't take a stock bonus, collected a salary of $81,840 and had $1.6 million in personal security costs that Amazon covered.)
However, there's still more work to be done for the company to reach more Americans:
But that figure only gives a surface-level view into the success and current challenges of Amazon's loyalty program — chief among them, how to keep growing in the country where Prime is the most popular and the biggest money-maker: Right here in the U.S. [...] As of August 2016, 60 percent of U.S. households with income of at least $150,000 had Prime memberships, according to research from Cowen and Company. Compare that with around 40 percent of households that made between $40,000 and $50,000 a year, and just 30 percent of those who earned less than $25,000.
[...] In 2017, Amazon unveiled Amazon Cash, a way for shoppers who don't have credit or debit cards to load money into their Amazon accounts by handing over cash at partnering retail stores. In the process, one roadblock to shopping on Amazon for those without bank accounts was lowered.
Two months later, Amazon introduced a 45 percent discount to the Amazon Prime monthly fee for those shoppers who receive certain forms of government assistance; the service cost them just $5.99 a month. And just this March, Amazon added Medicaid recipients to the group eligible for that discount.
Related: Amazon Prime... For Medicaid Recipients
(Score: 1, Troll) by Anonymous Coward on Thursday March 08 2018, @01:06PM (30 children)
Although, this time, it's being used for good!
Amazon is looking to get into the health-care business, right? So, they're trying to build a user-base among those who most struggle with health care: The old and poor. Amazon is embracing the Medicaid program within its current domain of expertise; next, Amazon will extend its expertise to include health care management; then, Amazon will work with governments to extinguish the public program, and we can be free once and for all from the ineptitude of "public" control.
From the description, it looks like Amazon might have the same idea for the other aspects of the welfare state. Why bother challenging the governmental programs when you can just infiltrate and then subsume them? Bezos is a genius.
(Score: 5, Interesting) by fyngyrz on Thursday March 08 2018, @01:55PM (24 children)
The thing about Medicare/Medicaid is that it is funded by the rest of us, with the specific aim of funding those who are not, generally speaking, able to fund it for themselves. The "welfare state", as you called it.
Amazon's means of funding such services will be from the end-user; not from the rest of us.
What this will effectively do, if it is the only option available to these low-income folks, is shear off the bottom tiers of those who need care.
Aside from that, right now, the government's various safety nets, as lousy and eroded as they are, address a lot of healthcare needs, both directly and through insurance support programs. In this environment, with all that already handled, private sources have not come even close to picking up the remaining slack – millions of people remain without adequate (or any) healthcare. Even more so since the ACA has been interfered with by the current administration, and more yet to come.
The often bandied about assertion that private enterprise should be left handle healthcare needs and all would be well is not even true enough to handle the fraction of healthcare needs that remain now; there's no reason at all to accept any assertion that they would do so if the portion the government covers now succumbed to such ideas.
When you cheer the privatization of healthcare for the poor, you're cheering for vastly worsened circumstances for them. If that's what you intend to do, by all means, carry on. But as you do so, let's not pretend that private healthcare will be better for the poor in any way, shape or form. It might be better for (some) taxpayers, in particular those who can afford their own healthcare; it might seem better for the presently healthy taxpayer who cannot afford their own healthcare, but that is an illusion brought about by self-deception or ignorance.
For my part, I pay the taxes without protest. I think it's one of the few things the government does that is actually worth doing – you don't want to even get me started on the list of things they do that aren't. While Amazon's approach here may well benefit middle tier healthcare customers, I'm under no illusions that it will, in any way, address the lower tiers. For that, we have to spread the costs out.
(Score: 1, Interesting) by Anonymous Coward on Thursday March 08 2018, @02:25PM (16 children)
Not only would a private organization have to compete with a violently imposed monopoly, but it would also have to fund the very competition with which it is supposed to be competing.
The VIM is the reason that the health-care industry is so horrifically distorted; nothing about it is normal.
The insurance companies have been converted into specialized payment networks that divorce consumers from producers, a frankenstein creature that is the natural consequence of governmental meddling beginning during World War 2 (and probably before).
(Score: 3, Insightful) by VLM on Thursday March 08 2018, @03:04PM (2 children)
There seems to be a lot of LARPing that we currently live in a white European country paradise of socialized medicine and some Dr Seuss-style capitalist villain is going to set up something worse than our current system because like a Bond villain he enjoys inflicting pain.
The reality is we have one company which admittedly a significant fraction of the population distrusts or hates, which has a gold plated incredible logistics system, is about to wipe out an industry of somewhat less well run companies.
Its like fretting as if the the orks are invading in LOTR (Or the orks invading Europe?), when the reality is its a lot more like the local GM dealership is about to get wiped out by the new Toyota dealership and life is gonna go on as it was, other than you'll get a slightly better deal for your money.
(Score: 2) by HiThere on Thursday March 08 2018, @07:10PM (1 child)
It's not at all clear that you'll get a better deal for your money, but you might get more reliable home delivery. There's no reason to assume it would be worse in all respects.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2) by VLM on Friday March 09 2018, @03:15PM
Agreed with the caveat that more reliable home delivery IS a better deal for your money, so even then... Thats why I kinda liked my standard SN automobile analogy in that Toyotas are generally not cheaper than GM but the "total lifetime cost of ownership" is likely better overall, aside from intangibles like driving a better car.
(Score: 5, Insightful) by fyngyrz on Thursday March 08 2018, @05:17PM (8 children)
Roads, fire departments, huge numbers of charities, etc. Your "VIM" is entirely too hysterical, even if technically accurate. People / organizations – some of them – do compete, or at least operate in the same space. It's outright ridiculous to hold that up as an excuse for letting people suffer.
The fact is, without government, and many of its "VIMs", you'd be completely out of luck. Healthcare, in fact, is one of those areas where that's exactly what happens to many people.
Some people do exert themselves in a charitable manner. The point was, and remains, that not nearly enough of them do despite the obvious needs, and based on the lack of response to those obvious needs at a relatively lower level, there's no reason to think that if the need was greater, that the coverage would somehow be more comprehensive.
Insurance is a way to pool funds against risk, and (ideally) get the funds to those who need pay for the services. This is not an unnatural consequence of a free marketplace where risk is a profoundly significant factor.
Government propped-up insurance – the ACA – was intended to increase the pool coverage. It was doing so, hardly ideally, but still it was doing so to the tune of tens of millions of newly covered individuals, and now is degrading rapidly in its end effects because it's been maliciously interfered with rather than actually honed towards a more effective end that more closely approximates what it was intended to do.
I am all for single payer healthcare and leaving the health insurance industry in the dust. But make no mistake: it's still pooling money and sharing it out to the providers of healthcare. The difference, hopefully, is it wouldn't be leaving people out, which is a severe fault of almost all free market pool systems.
As far as I'm concerned, the healthcare insurance industry and the individual-payer healthcare system are both long past their sell-by dates; government, however, is not.
(Score: 5, Insightful) by cmdrklarg on Thursday March 08 2018, @06:33PM (3 children)
The ACA has been maliciously interfered with from day 1. It would have been far more effective without red states actively undermining it. With the current administration it is also able to undermine it further.
The world is full of kings and queens who blind your eyes and steal your dreams.
(Score: 2) by schad on Thursday March 08 2018, @07:10PM (1 child)
This is an entirely predictable and natural consequence of trying to make a bunch of people do something they don't want to do. Of course they'll try to undermine it at every turn! Why in the world would you ever have expected otherwise?
It's really exactly the same as what's going on now with immigration, where certain elected officials are basically doing their best to undermine the federal government at every turn using all legal authority they have. In some cases their authority may not even be legal, but until SCOTUS says "no" they still get to do it. Even after SCOTUS says "no" they may continue to do it. There are a lot of ways to get out of doing things you don't want to do, and it takes a lot of court battles -- and a lot of time -- before anyone will force you to do it.
Thus, if you want health care reform, you need to convince a clear majority of the country that you need it. Anything less and it won't work.
The good news, assuming you're an advocate for single payer, is that the systematic dismantling of Obamacare is likely to result in at least a few states joining Massachusetts in the ranks of universally insured. Some of them may even go so far as single-payer. If those experiments work out as well as their proponents would like to believe, they'll quickly spread to the rest of the country. Ultimately we'll get something nationally, and there you go.
(Score: 3, Insightful) by VLM on Friday March 09 2018, @03:17PM
Historically very low impact. You need to convince a majority of election campaign and national committee donors that you need it.
(Score: 0) by Anonymous Coward on Friday March 09 2018, @08:11PM
Then maybe the Democrats should have just done single payer when they had a supermajority. Instead, we got this mess which doesn't fix the fundamental problems with our health care system; we didn't even get a public option. The Democrats are overall not a very progressive party.
(Score: 2) by HiThere on Thursday March 08 2018, @07:21PM (3 children)
Healthcare comes in many different cases, some of which are better handled by universal health care, and some by insurance.
Insurance *should* be risk pooling. US insurance is more nearly an extortion racket. But back to health care.
case 1) Basic health care is going to be needed by everyone. Insurance is a bad model for this, as it merely invokes additional parties to be paid.
case 2) Rare events. This is something that say, 1 in 100 people would have happen to them during their lifetime. One can reasonably argue that this case is justifiably covered by insurance.
case 3) Optional or cosmetic surgery. This doesn't need to be covered by basic care, and whether insurance should cover it depends on the policy...usually it won't. Save up and pay for it yourself.
case 4) Public Health. This should definitely be wholly funded by the government. You want contagious diseases suppressed.
I've artificially created descriptions that seem to have clear boundaries, but they don't. One can rationally argue exactly where each of those boundaries should be. My preference would be to have basic health care expand to include rare events, and get the insurance companies totally out of the health care business.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 0) by Anonymous Coward on Thursday March 08 2018, @07:50PM
Your "Public Health" category doesn't imply that governmental funding is necessary.
Rather, that too is a matter of risk management; a robust industry of insurance that actually manages risk would be naturally induced by market incentives to set rates in such a way that individuals and organizations take steps to reduce the risk of wide-scale epidemics. For instance, insurance companies could offer premium reductions to airports that screen passengers for sickness. Families could be given reduced premiums for getting their children vaccinated, or for getting a flu shot, etc.
Now, maybe in the present organization of society, this kind of large-scale risk management is not logistically feasible, but it's not impossible; strictly speaking, "government" is not a necessary solution. Indeed, anybody who is interested in living in a society that could be called "civilized" should be interested in replacing the "government" with something more voluntary, anyway, and that basically means replacing "government" with capitalism.
(Score: 2) by VLM on Friday March 09 2018, @03:23PM (1 child)
Cases 1 and 2 imply property tax funding for medical care. Its a direct relationship.
Case 1 virtually all non-ER care my elderly ancestors get comes from the closest provider, and only 1/3 of the US people have jobs, so for 2/3 of the population, closest provider will always be closest to home, where you pay prop tax.
Case 2 if your transportation system is sub-par or your residents are shitty people, the ER is going to get a lot of incoming trauma patients. Suburbs not so much.
As far as socialism BS arguments, health care boils down to the same argument as everything else in the local prop tax budget, everyone living here gets what they paid for, however high or low. Parks and rec, schools, police, fire, DOT, etc. Essentially we're already implemented this except with numerous well paid middlemen and we refuse to do it directly, so we do stealth prop tax by billing everyone who lives here for the local monopoly hospital provider via W-2 paycheck deductions, which is a stupid way to pay a property tax.
(Score: 2) by HiThere on Friday March 09 2018, @05:41PM
There's some legitimacy to your argument, but you'll need to take it up with the supreme court. They decided that cities and counties could not have a residency requirement for social support services.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2) by DeathMonkey on Thursday March 08 2018, @07:52PM (3 children)
Violently Imposed Monopoly
Watching people die in the streets seems pretty violent to me.
(Score: 0) by Anonymous Coward on Thursday March 08 2018, @07:58PM (2 children)
Don't stick a gun in my face and try to make me do something about it—especially when your solutions are so stupid, anyway.
The most robust solutions come out of agreement, not coercion; civilized society is an act of individual will, not mandate.
(Score: 2) by DeathMonkey on Thursday March 08 2018, @08:35PM (1 child)
Don't stick a gun in my face and try to make me do something about it
Without a monopoly on violence what's to stop me from sticking an actual gun in your face to pay my medical bills?
(Score: 0) by Anonymous Coward on Thursday March 08 2018, @09:17PM
My own prevention, and my own retaliation.
Your government police show up after the act, not during the act. And, as a violently imposed monopoly, there's not much incentive to do a good job, anyway.
There's an incentive to protect oneself, or to band together with like minds to protect each other. Neither is your "government" solution sufficient, nor is it necessary.
(Score: 3, Informative) by frojack on Thursday March 08 2018, @04:03PM (1 child)
Do not lump Medicare in with Medicaid.
They are fundamentally different.
No, you are mistaken. I've always had this sig.
(Score: 2) by fyngyrz on Thursday March 08 2018, @04:32PM
They're both significant components of the social safety net.
I'm not saying they operate the same or at the same governmental level.
(Score: 2, Insightful) by khallow on Thursday March 08 2018, @05:24PM (4 children)
And that's how entitlements become a bribe for the status quo. You knuckle under to the corruption just because there are a "few things" that you approve of. The scary people that would fix that corruption would also cut your favored programs, because those are out of control spending. It's a shame that so many people chose the quick buck now rather than a future later.
(Score: 5, Insightful) by fyngyrz on Thursday March 08 2018, @06:25PM (3 children)
It's definitely much simpler than that. Letting people suffer health issues that they aren't into suffering, which could be ameliorated, is not something I can get behind.
You personally want to have no medical care and suffer some serious problem? I'm right behind you. Suffer away. I'll take pictures and write snarky comments, maybe try to sell your body parts as they fall off.
But for those who don't want to slide down the masochistic razor blade of life, I think we're well past the level a society needs to get to where it not only can help, it should help.
The rest of the social-safety-net arguments are all low-level noise to me. Government has no monopoly on corruption – the private sector's record in dealing with the poor is awful – nor do I think that throwing out the baby with the bathwater is advisable here. Don't let the perfect be the enemy of the good, or even the adequate. Set something up that works (the ACA works with the established insurance industry, for instance), then improve it. If you want to replace it, by all means, but make sure the replacement is better. Otherwise, you're just imposing unnecessary suffering, no matter what excuses you might try to field to explain your behavior.
(Score: 2, Funny) by khallow on Thursday March 08 2018, @06:29PM
Well, they can't scare you by withholding Halliburton's swag, can they?
(Score: 0) by Anonymous Coward on Thursday March 08 2018, @07:05PM (1 child)
It does in the sectors over which it has declared itself a monopoly.
(Score: 3, Interesting) by fyngyrz on Thursday March 08 2018, @09:11PM
Oh, does it? You mean like regulating recreational drugs such as alcohol and pot and so forth, in allowing and disallowing and sales? Surely you see no extra-governmental corruption there, eh? How about WRT the control of the airwaves - no, no corruption in the private sector there, right? How about in tax collection? That's 100% government, right? And not a single bit of corruption in the private sector WRT taxes, right? Right? What about patents? Totally a government monopoly. Surely there's no private sector corruption around patents! Private sector use of copyrights corrupt? IMPROBAPOSSIBLE©! Legislation? Legislation is all-government, all-the-time. And the largest corrupt influence on that? The bloody private sector, that's what. The courts? Again, 100% government monopoly. Private sector never corruptly involves themselves there, right? FFS.
No. Turns out, you have zero idea whatsoever what you're talking about.
The government establishes a monopoly in some area of any real consequence, the private sector often enough weasels right in there and turns it into a slimy mess. Which areas? Why, the ones with large enough amounts of money at stake and available to wave around, of course.
Human nature, as amply demonstrated by all manner of private entities: The "haves" will inevitably try to lord it over the "have-nots." They will drone on about how the lowly deserve to be low because reasons, and the lowly should suffer because reasons, and the lowly should be grateful because reasons, and on and on and on. While this goes on, the money trickles up, and the disadvantages waterfall downwards. Leroy Moneybags III has his yacht and his facelift, and Joe Poorboy has his ramen noodles and his unrevised hernia. All is right with the world because reasons. No. Just no.
A good bit of this is why we can't actually get along without government. People are selfish, mean, and heartless, and the more leverage they have, the more likely those particular flaws will float to the surface as steaming personality turds. Our (US) form of government, for all its myriad flaws, tends to buffer that stuff and expose more of it than the typical private entity – and our government at least has often recognized it actually has a responsibility to the people, something many – most – private entities would just as soon you never brought up.
Yeah, government is corrupt as hell, and it's annoying when things don't go perfectly, or even well. But don't even bother to try to tell me that private enterprise is very likely to do it better. Responsible businesses with real social consciences are pretty bloody rare.
You know that bit about "corporations are like people"? Yeah, they are – and the people they are like are the psychopaths and sociopaths.
(Score: 1) by cocaine overdose on Thursday March 08 2018, @02:04PM (4 children)
Benzos' plays have been astounding so far, but I'm not looking forward to seeing a monopoly on healthcare (moreso than now!), that will invariably come if this testing-the-waters succeeds. But I am excited to see how Bongos will deal with the absolute clusterfuck of Customer Support that will come from all of this. Amazon is already pretty awful in timely and useful customer response, and the majority of which (the customer service handlers) are from stay-at-home mom contractors and other "make easy money from home types." HIPPA's gonna be a nightmare.
And Amazon has been growing massively huge, the things it can get away with have grown and I'm looking forward to see what path its demise will take, down the road. Will he fade into obscurity like IBM? Will governments decide (HA!) his tentacles have reached too far and dissolve him like Standard Oil? Maybe we'll see something new, like Bannanoz wage a war against the world and take Morocco as his own nation-state. Now if only the history books to be written can capture the complex emotions of the time. Surely the Athenians had such times, but everything on them is sterilized.
(Score: 2) by VLM on Thursday March 08 2018, @02:57PM (3 children)
My guess is we're going to see a monopoly on pharmacy business rather than healthcare in general. Walgreens and CVS long ago killed the last independents around where I live, also employer incredibly strongly pushes mail order refills which are cheaper and more convenient, and now they're all about to get wiped out by Amazon. I wonder how Amazon is going to work around legacy pharmacist make-work laws, and how they're going to work around controlled substances or abuse substances. Possibly the only reason they haven't already wiped Walgreens off the map is because they have no idea what the answer could be.
Things that suck get their named changed a lot; a quarter century ago we had "WIC" (pregnant) women infants and children, probably renamed ten times since then, where the .gov wrote the worlds weirdest check with numerous detailed requirements such that poor mothers could get precisely, and only, one quart of milk, exactly 12 oz of cheddar cheese, one 16 oz bag of beans and one of rice, etc etc. I worked at a small supermarket while in school and WIC checks were a documentation nightmare such that when I helped out cashiering if a WIC check came thru I'd call for help. There were elaborate anti-fraud procedures for the store employees to follow, involving much paperwork. Anyway, my point is doing all that documentation and logistical stuff with amazon's legendary systems would imply the future of welfare might be the old concept of WIC checks on steroids... rather than buying and selling food stamps at dive bars as was standard operation procedure in the old days, the .gov will decide exactly what poor people purchase and have amazon deliver exactly that to their homes, which will be interesting.
(Score: 3, Funny) by Runaway1956 on Thursday March 08 2018, @03:51PM
The pharmacy monopoly has been in the works for about 30 years now. Walmart is the culprit. So - Amazon may out-monoplolize those hillbilly Waltons? I don't know which side to cheer for.
(Score: 1, Interesting) by Anonymous Coward on Thursday March 08 2018, @07:13PM (1 child)
WIC is easy now, it's all done off the same card food stamps come on. Just swipe, the system WICs what's WICable, EBT's the rest, and cash benefits or actual cash for the rest.
(Score: 2) by VLM on Friday March 09 2018, @03:11PM
Really? Well I suppose cash register systems are somewhat more complicated now than in 1990, its believable. Most of the foolishness they put us thru was to prove lack of not just recipient fraud but corporate fraud too. Staple the receipt to the deposited check and write some number from the end user ID on the receipt to prove the check and recipient relationship was 1:1 and we had to deposit the checks specially so they needed special handling in the store, it was a mess.
In that case I guess Amazon would have to rely solely on their logistics empire.
(Score: 5, Interesting) by JoeMerchant on Thursday March 08 2018, @01:58PM (15 children)
Medicaid recipients are required to have less than $2000 in liquid assets, and some ridiculously low income, and Amazon thinks it's a good idea to sponge $71.88 per year from these people so they can get faster free shipping?
What this really is is a program for Medicaid recipients to sign up for Amazon Prime cheaply so that other people can buy things through their account.
🌻🌻 [google.com]
(Score: 2) by VLM on Thursday March 08 2018, @03:18PM (5 children)
I have a beyond elderly Uncle-in-law on medicaid in assisted living, no particular reason, just old in many ways, anyway, your argument seems to be that its bad that Amazon will accept less money in exchange for one of his prime-less nephews visiting him more often. I mean, you clearly think there's a problem so expand on it?
Taking your side of the argument to see if I understand it, I'll concede the point that being nearly immobile, he's in more of a monopoly situation than a Prime subscriber like myself, because I can drive to Walgreens in about five minutes anytime I want, but for someone with my UiL's mobility going to the store would be like me entering a marathon, so they're probably going to abuse the monopoly position into ridiculous higher prices. Good luck getting me to pay $15 for a hundred advil pills, but my UiL being immobile would have to cough up the cash or do without.
Ironically that argument sounds like an amazon commercial in that the best way, maybe the only way, to make sure my UiL isn't screwed over would be for me to continue to do business with amazon while holding their feet to the fire WRT prices. Go ahead Amazon, make my day, try to charge $15 for a hundred advil, I'll get pissed off enough to drive to walgreens and buy two bottles, one for me and one for my UiL... Hell I'll make walgreens even more profit and buy him two bottles, old people love to hoard, its not a problem.
(Score: 2) by Runaway1956 on Thursday March 08 2018, @03:59PM
I KNOW you are quite literate. But, man, that first sentence? There's nothing funny about what you're saying, but you appear to be a little worked up. :^)
Alright - on topic. I'm with you. Becoming a Prime member may well make some people captive audiences. Personally, I've resisted the occasional urge to join.
(Score: 4, Insightful) by JoeMerchant on Thursday March 08 2018, @04:57PM (3 children)
I've done the "prime trial" twice now, and the things it did for me were:
1) got things to my door a few days faster, sometimes.
2) access to "Prime Pantry" and their movie service
3) enticed me to spend more money at Amazon, which we all know is the real purpose of Prime - regardless of price.
>123 $5.99 per month, from people who already don't have enough money to make ends meet, just so they can access some basically premium services that nobody really needs? That's my point. I would approve if it were free, but this is like the old George Carlin joke about overdraft charges at the bank: "charging you more of what they already know you don't have enough of..."
🌻🌻 [google.com]
(Score: 1, Informative) by Anonymous Coward on Thursday March 08 2018, @07:18PM (2 children)
Prime used to be just a bit faster for me. Now, Amazon holds everything I order for a week before shipping and then ships it in a day. I'm assuming economies of scale and efficiency are the reasons behind this, but I fucking hate Amazon for it and go out of my way and pay higher prices just to spend my money elsewhere.
(Score: 2) by VLM on Friday March 09 2018, @03:30PM
I admit I've noticed the std deviation creep up over the years, in the old days, "two day shipping" meant "two days" but now it seems to mean "sometimes free same day if over $25, sometimes next week, but it averages out to two days".
To some extent it doesn't matter, if I need it right now, like we're out of toilet paper, then I can't Amazon, but if I merely need it soon, then a few days here, a few days there, it doesn't matter.
What they have not waffled and redefined yet is it remains true its like an insurance policy that you'll never pay UPS or whomever more than $X per year, ever. I'd drop it like a hot potatoe if they started randomly charging for prime or for shipping based on their dice rolling.
(Score: 2) by goodie on Friday March 09 2018, @03:45PM
Well, that's been my experience as well. I'm pretty sure that their argument is "fuck you, get Prime or wait like back in 1995". Personally, I don't care, if I really need something, I go to a store. And in 99.99% of the cases, I don't need it that bad, that soon. My wife signed up for Prime and loves it but I haven't yet. I still order from my account and she always wonders how I can live without Prime :D. The one advantage for the target population is that they can have stuff without a minimum purchase amount to be eligible for free shipping. If you really want to be nice, just give those people free shipping without Prime, that'll be a real nice move.
I like having the choice of going somewhere else. One day, when all we have left is Amazon, people will be like "WTF, Amazon are a mean company that takes advantage of its monopoly!". But the thing is that if that ever happens, it will be because we will have handed them the keys. Short-term, pure price-driven decisions are not usually a good thing for the long term. This is a moot point for those who cannot afford to pay more, but for those who can, I think it's worth considering.
On the other hand, I don't like getting shafted when I go to a store. So sometimes, I do buy from Amazon because it is literally 50% cheaper. Thankfully, Amazon now behaves more like a regular store: sometimes you'll see that some items are actually a lot more expensive on Amazon than in the store so that helps too :). They just count on the fact that you buy one cheaper you won't mind one for a lot more.
(Score: 4, Insightful) by GreatAuntAnesthesia on Thursday March 08 2018, @03:44PM (8 children)
Isn't it also true that people with less money / assets / income are less likely to own a car? And that people without a car in the USA have real difficulty getting to the big out-of-town shops where the best prices are, and even more difficulty difficulty transporting heavy purchases (such as a week's worth of groceries) home again? And don't Amazon sell groceries nowadays?
If I was a poor person in America, and I didn't own a car, I would be giving serious consideration to this as a way of getting cheap necessities delivered for almost free.
Furthermore, if I were poor but DID own a car, I would be seriously looking at whether this service would allow me to ditch the expense of owning a car altogether. If I could get to work on the bus (or didn't work at all) and lived within walking distance of family & friends, then why not?
(Score: 2) by JoeMerchant on Thursday March 08 2018, @05:09PM (1 child)
Maybe in limited markets like Seattle... Amazon Prime Pantry is no substitute for a grocery store.
Nice thought, but Amazon (for me) is mostly a way to stay out of the shopping malls - premium luxury optional goods, not a reliable or complete or particularly cost-competitive source of "essentials."
Back in 2002, our local (serving a 300 mile radius) grocery chain trialed an internet shopping direct delivery to the home program - we had a new baby and participated heavily, probably >90% of our groceries came by direct delivery over a 6 month period. I think they charged $10 per order, but frequently ran specials for free or much reduced delivery fees. Their minimum order was $50, but we tried to keep our minimum closer to $200 to cut down on the delivery fee percentage. They drove a refrigerated truck direct from the distribution center (200 miles away) to our neighborhood and brought the groceries into the house. I wish that program were still running, it really could enable some people to get rid of their car. Groceries are the essentials of life - not books, DVDs, electronic gadgets, etc. Amazon Prime Pantry does deliver some groceries to most of the US, but not enough to really live off of. They also have a couple of trial markets for full grocery delivery, but less than 1% of the US population is served by those.
🌻🌻 [google.com]
(Score: 0) by Anonymous Coward on Thursday March 08 2018, @07:06PM
Here where I live, Safeway, Sprouts, and I think King Soopers all offer home delivery of food.
Sprouts promises a 1 hour delivery time I believe.
(Score: 1, Disagree) by Phoenix666 on Thursday March 08 2018, @07:27PM (5 children)
People in America need cars because they think they need cars, not because they actually do. How do I know this? Because there are many other places in the world where people manage without cars. I once saw an entire dining room set, including the table and all six chairs, being pedaled down the road on a cyclo in Saigon. In Beijing, I've seen cargo bikes resupplying grocery stores. In NYC, all kinds of immigrants get around perfectly well with bikes, even e-bikes, because they can't legally drive. When I was a kid, living in the Rockies, I worked with a bunch of guys who were all part of the local cycling club; they laughed and laughed at all the suffering drivers during one of the oil shocks because none of it affected them (and those guys biked year round up and down mountains, through all weather).
I have a car, and like having a car. But it's not necessary.
At the end of the day, Americans especially could use more exercise, and the way things are going they really ought to ditch their cars and put all the money they'd accordingly save into investments for retirement, because god knows Social Security will have been sucked dry long before the Baby Boomers are done.
Washington DC delenda est.
(Score: 3, Insightful) by NewNic on Thursday March 08 2018, @08:50PM (4 children)
I have seen an entire kitchen's worth of cabinets and other furniture being transported on a gondola down a canal. So, using your logic, we can use gondolas for all our transport needs?
Just because something works in one country, doesn't mean it will work in another.
For many people, the options are: travel by car or ... can't get there. Bikes are not a viable solution for many people*. The real reason for this is that public transport is underfunded in the USA. Would you care to do something about that?
* The USA has developed with the assumption of motorized transport being almost universally available. The US is not like most other countries in this respect.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: 2) by Phoenix666 on Thursday March 08 2018, @10:29PM (3 children)
You're right. My mistake. Bikes totally can't travel on solid ground called roads. Also, other countries have a compound called oxygen in the air that humans can breathe. The United States only has methane, so people totally couldn't breathe outside a car.
JFC, it's not that Americans cannot bike, it's that they won't. The average commute is 23 miles. A person can bike that. Given the traffic in the Tri-State area (and many other places), a person on a bicycle would very often get home faster on a bike than sitting in a car. Also, they'd save time because they wouldn't need to make an extra trip to a gym.
We don't have to speculate or theorize how life would be possible without cars, because those places already exist and function rather well. I myself lived in Japan, no Third World, pre-industrial nation, and never had a need for a car despite travelling all over the prefecture from the cities to the middle of the rice paddies on a daily basis.
Washington DC delenda est.
(Score: 2) by NewNic on Thursday March 08 2018, @10:41PM (1 child)
Most of Japan has much better public transport than most of the USA. Or are you claiming that you cycled everywhere?
A lot of people in the USA commute on limited-access highways (freeways or tollways) and there isn't a viable route for bikes.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: 2) by Phoenix666 on Friday March 09 2018, @02:36PM
I did cycle everywhere. I was in Saga Prefecture on Kyushu. It was quite rural. There was no subway. There was a light rail spur that connected Nagasaki to Fukuoka, but didn't fan out into the prefecture. Buses were infrequent.
There is even less room for bikes in Japan than there is in the United States, yet I biked everywhere. Most roads don't even have shoulders you can ride on, much less bike paths. Very often there is an abrupt edge to the road and a 2-3 foot drop into a rice paddy. Riding at night can therefore be quite tricky, with no street lights or nearby homes to light your way, only ambient light on the horizon, starlight, or a bike light.
In short, there's no real excuse for Americans to not bike more. They just don't want to, or they've been brainwashed by generations of Detroit's advertising into thinking cycling is incredibly impossible or dangerous. If you throw in aftermarket e-bike kits that are common now, there's even less excuse.
Washington DC delenda est.
(Score: 0) by Anonymous Coward on Friday March 09 2018, @11:48PM
It's not allowed to bike or walk on many highways in the US (yes even on the shoulder). So yeah, I can walk and get some places, but to leave the state or even travel to another town in my county, I absolutely have to have a car or I'm breaking the law, as well as rising life and limb trying to cross 6 70mph lanes. Living without a vehicle means being corralled and having very few options for anything.
(Score: 2) by opinionated_science on Thursday March 08 2018, @03:39PM (26 children)
One of the most astounding figures I read recently was that Medicare (for >65) is $1.3T , and Medicaid (poor and usually 65) is $1.7T.
So the US Govt pays $3T for healthcare, whats that per capita compared to Europe etc..?
(Score: 4, Insightful) by GreatAuntAnesthesia on Thursday March 08 2018, @03:50PM (6 children)
With the US population at about 300million, that's ten thousand bucks per person, per year.
I wonder how that compares to the actual average COST of healthcare per person, as opposed to the hugely inflated PRICE of healthcare under your current insurance system.
(Score: 0) by Anonymous Coward on Thursday March 08 2018, @03:55PM (4 children)
Also, as the other AC pointed out, "insurance" is a misnomer. It's a bizarre payment system, not a risk management system.
(Score: 4, Insightful) by GreatAuntAnesthesia on Thursday March 08 2018, @04:12PM
Good point. If I were in a slightly more cynical mood today, I'd probably also say that the term "healthcare system" is a misnomer as well. From here it looks more like an obscenely complex healthcare-denial system.
(Score: 4, Insightful) by NewNic on Thursday March 08 2018, @06:16PM (2 children)
Actually, it's more like a hybrid, but, with increased deductibles and out-of-pocket maximums it is transitioning to a pure insurance system.
Yes, medical insurance may pay bills that you could afford, such as visits to your doctor, but how many people could afford any amount of surgery?
The whole system is a mess, with a typical simple operation being "billed" at $50k - $100k, while the payments from the insurance for this operation are probably 1/10 of the billed amount. Similarly, I don't believe that my insurance actually pays $600 for a 15 minute consultation with a specialist doctor.
Some years ago, my insurance paid for an operation for my wife. The insurance paid about 7% of the total billed amount and I had nothing to pay. And yet, had I not had insurance, I would have been luck to get a 50% discount, not the 93% discount that my insurance company got.
Basically, the medical industry in the USA is ripping off the population.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: -1, Troll) by Anonymous Coward on Thursday March 08 2018, @06:26PM
Whether or not I get a flu shot, or vaccinate my child, my premium remains the same.
That's not risk management.
Now, extrapolate.
(Score: -1, Troll) by Anonymous Coward on Friday March 09 2018, @12:35PM
Whether or not I get a flu shot, or vaccinate my child, my premium remains the same.
That's not risk management.
Now, extrapolate.
(Score: 3, Interesting) by JoeMerchant on Thursday March 08 2018, @06:14PM
It's hard to get a clean breakdown, but from my perspective what I see is:
$10K per capita going into Medicare/caid programs.
$1K per capita going to top level GAO (general accounting overhead) - oversight, audits, program reviews, anti-fraud task forces, etc.
$2K per capita going to bottom level GAO - application processing, eligibility review, ongoing review of eligibility status, bureaucratic offices filled with surly and willfully ignorant agents who are pretty much the opposite of Bob Parr [youtube.com], payee eligibility reviews, anti-fraud audits, etc.
Actual fraud is hard to gauge, but I think the system is running at a pretty optimal balance where they spend just about as much preventing fraud as the remaining fraud in the system, call it $500 per capita.
So, hey, that's not so bad: $6500 per capita going toward actual healthcare, right? And, it's not as if the $3500 per capita is wasted, all those bureaucrats have jobs, participate in the local economy, etc. Hell, even the fraudsters are out there buying luxury goods... it's still beneficial to the economy.
But, as GreatAuntAnesthesia pointed out, that's $6500 feeding the PRICE of healthcare side of the machine, not the COST, so slice another 50%+ off of _that_ to feed the GAO, profit centers, and fraud in the insurance and reimbursement layers of the system.
My mother in law is in Assisted Living, and one aspect of her Assisted Living program is a Medicaid eligible $19/day fee for, basically, someone to look in on her every 2 hours. On paper, they are supposed to be assisting with bathing and other activities of daily life, but in reality they give her her pills once a day and are otherwise "on call" incase she falls or something (which has happened more than once...) For a big assisted living facility with maybe 120 residents, there are usually about 2 LPNs on staff who provide this $19 per day service to all 100+ residents, plus other things too. 3 shifts, 6 LPNs generating $1900+ per day of income for the facility whether through private pay or medicaid. The LPNs don't get $40 per hour, they get more like $20/hr, the rest seems to get sucked up into GAO.
🌻🌻 [google.com]
(Score: 4, Interesting) by tizan on Thursday March 08 2018, @04:41PM (13 children)
Don't forget only a small fraction goes to financing health issues...most of it is sucked by private health related companies "scamming" the system.
Here a health transportation company will charge medicaid $45 or so for medical related trip when a taxi would charge $7 for the same trip (ok there is an overhead to file for the reimbursement etc... still say they charged $10 or $15 ....but $45 shows how the lobbyist for these service companies are managing to sell this to politicians).
Poor people needs it but most of the money spent is taken by private insurance, providers etc way more than the value of service provided.
It would be better off if poor poeple go to government hospitals system like the VA and use government run transportation...but that is too communist in this country because it might be cheaper than private providers alternative.
We know the government does things cheaper when they are well managed...just compare private contractors to the US army ?
(Score: 4, Interesting) by stretch611 on Thursday March 08 2018, @05:34PM (12 children)
Makes you wonder why we don't just have government run healthcare for all here in the US.
The government's healthcare bill is not just the amount mentioned for Medicaid/Medicare. It also includes the VA... and active duty military... and the president... and congress... and all the millions of people that work for the government.
Between the old, the poor, and all the government employees (both military and non-military) a huge portion of the US population is already getting its healthcare bill paid by our government. If we get rid of the profit minded middlemen (aka the insurance companies) the savings from that will probably more than pay the price of insuring all of the rest.
In addition, go into any doctors office today... practically every single one has at least one full time worker dedicated to just dealing with insurance companies. When insurance verification requires just a drivers license (or SSN) all of those duties will be reduced to practically nothing saving even more money.
Of course yes, healthcare for all is a socialist/communist policy so it must be evil and discounted by any thinking person... bullsh!t!!!
I still remember the opposition mantra back when Obamacare was being created... one huge argument was then you have the government making life or death care decisions(approval/denials) for people needing medical procedures. That argument fails horribly when you compare it to the profit-minded insurance companies that make those decisions now.
Now with 5 covid vaccine shots/boosters altering my DNA :P
(Score: 0) by Anonymous Coward on Thursday March 08 2018, @06:29PM
So much of health care is dominated by the government already, and yet it's a clusterfuck.
The only thing going for the current system is that what does exist of a private sector is the driving force behind the entire planet's medical innovation.
(Score: 2) by NewNic on Thursday March 08 2018, @06:33PM (10 children)
Because too much of the population have been brainwashed into thinking that "taxation is theft" and that the government is full of corruption and waste while private companies are entirely free of such issues.
There was a teacher in West Virginia who was on strike for better pay, but didn't see the connection between low taxes and no money for education. It's those people who would prefer to pay 10x as much to a private company than pay for something through taxes.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: 1, Informative) by Anonymous Coward on Thursday March 08 2018, @06:57PM (9 children)
If a private company is full of corruption/waste, at least I can choose to do whatever I can to avoid funding that company; I can use alternatives, I can choose to do without, or I can even band together with like minds and make an entirely new company with which to compete.
You don't have that choice if the service provider is the government.
That's the difference; that's what leads people to the word "theft".
Paying for the roads I use? OK. That's a just fee for usage/maintenance levied by the owner of the road.
Bombing roads on the other side of the planet? Throwing people into cages for growing a plant in the "privacy" of their own homes? No. You'll have to steal my money if you want me to pay for that nonsense; you'll have to stick a gun and my face and tell me to pay up "or else". That's not a just fee; that's taxation.
To borrow a phrase: Get it yet?
(Score: 2) by Bobs on Thursday March 08 2018, @07:16PM (1 child)
Of course you can vote, and run for office, and publicize problems, etc to motivate elected officials to change.
Versus the influence over a local monopoly or oligopoly, who owe their primary allegiance to maximizing a profit for their shareholders/owners, not you.
Elections do make a difference: Just ask the people trying to get an abortion, living in Quatar or Iraq, or the people in the US working on selling and installing solar, or trying to build things with aluminum or steel.
(Score: 0) by Anonymous Coward on Thursday March 08 2018, @07:27PM
That's why it's "theft".
Elections resulted in 100-year-old beer pubs being declared illegal and put out of business by men-with-guns.
Are you really going to argue there's no difference between that method of organizing society and capitalism? It's really all just the same voluntary participation?
Government is all about removing property rights against the will of the person who gathered those rights from his community; that's called theft.
(Score: 2) by NewNic on Thursday March 08 2018, @08:03PM (4 children)
No, [courthousenews.com] you can't. [npr.org] Unless you don't want that medicine at all?
The simple fact is that the UK shows that the largely private medical "system" in the USA is vastly expensive. Whether this is due to incompetence, illegal behaviour or simple greed isn't important.
But idiots like you would prefer to pay 10x what it should cost because, "hurr, durr, taxation is theft!".
I have no problem agreeing with you that the amount of money spent on the military is far too large. The problem is that any tax cuts inevitably don't address that issue: instead, they affect benefits and services for ordinary people.
As for locking up people for growing certain plants: in general the same people who don't want to pay taxes do support locking up people for what they grow in the privacy of their own homes. This is because they one thing they mostly have in common is an authoritarian attitude.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: 0) by Anonymous Coward on Thursday March 08 2018, @08:12PM (3 children)
It's like you see nothing but keywords that trigger your builtin copy/paste algorithm.
(Score: 2) by NewNic on Thursday March 08 2018, @08:41PM (2 children)
I see that you don't really want to engage in rational debate, but would prefer insults.
Two can play at that game: Go fuck yourself, you childish moron.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: -1, Troll) by Anonymous Coward on Thursday March 08 2018, @10:08PM
So. Yeah. "Go fuck yourself, you childish moron."
(Score: -1, Troll) by Anonymous Coward on Friday March 09 2018, @01:54AM
So. Yeah. "Go fuck yourself, you childish moron."
(Score: 2) by NewNic on Thursday March 08 2018, @08:12PM (1 child)
To add to my prior comments, I would bet that you actually voted for the party that wants ever increasing military spending and wants to lock people up for growing or taking cannabis.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: 0) by Anonymous Coward on Thursday March 08 2018, @08:22PM
Should I send you a Bitcoin address to pay me for having lost?
(Score: 2) by JoeMerchant on Thursday March 08 2018, @05:13PM
Yeah, but as a culture we're constantly shaming anyone who takes such benefits, painting them as a worthless drag on society - so you can't just extend those programs and give them to everyone.
🌻🌻 [google.com]
(Score: 5, Informative) by NewNic on Thursday March 08 2018, @06:04PM (3 children)
It's about 3x the per capita spending of the UK's National Health Service, while covering only 1/4 of the population, while the NHS covers 100% of the population.
So government in the USA spends about 12x more per covered person than the UK does and get poorer results. Yay, the free market at work!
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: -1, Troll) by Anonymous Coward on Thursday March 08 2018, @07:02PM (1 child)
Your argument is totally unpersuasive, because it's clear that America's free market in medical care is in the intensive care unit with a weak pulse. The few places where there actually is a free market (e.g., LASIK surgery) has seen rapid improvements in quality and cost.
Indeed, there are people on your side of this issue in these very comments [soylentnews.org] who point out the vast influence that a meddling, distorting, violently imposed government already plays in the health care sector.
(Score: 2) by NewNic on Thursday March 08 2018, @08:17PM
The cognitive dissonance required to blame government for the high cost of a service provided by the private sector is very high.
The reason Lasik is cheaper is that it is elective. People can simply continue to use grasses or contacts instead of having Lasik. The impact on quality of life is minimal.
Also, elective surgery isn't cheap in the USA. Go to almost any other country and you can get that plastic surgery much cheaper.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: 4, Informative) by DeathMonkey on Thursday March 08 2018, @08:42PM
Oh and it get's better!
The stupidity of Trumpcare: Government will spend $33 billion more to cover 8.9 million fewer Americans, as premiums soar [latimes.com]
(Score: -1, Offtopic) by Anonymous Coward on Thursday March 08 2018, @03:57PM (3 children)
Every soylentil is an old rich retired boomer. Exactly zero people here are on medicaid.
Irrelevant story is irrelevant.
(Score: 2) by kazzie on Thursday March 08 2018, @04:02PM
Especially those of us that don't live in the USA!
(Score: 1) by redneckmother on Thursday March 08 2018, @04:38PM
Guess again.
Mas cerveza por favor.
(Score: 3, Funny) by JoeMerchant on Thursday March 08 2018, @05:50PM
My mother in law is about 60 days away from qualifying for Medicaid, and we just sent a $300 "care package" to her via Amazon. Still won't be signing her up for Prime, tho.
🌻🌻 [google.com]
(Score: 3, Interesting) by archfeld on Friday March 09 2018, @05:05AM
Giving/funding healthcare to the poor and needy is most certainly cheaper than waiting for them to show up in an emergency room with no healthcare and being treated on the public dole. A national healthcare system in the US would save billions, but after the BigPharma and Insurance companies get done frankensteining any sort of bill or law what we get/got was so pork filled and flawed it barely benefitted anyone other than those 2 industries.
For the NSA : Explosives, guns, assassination, conspiracy, primers, detonators, initiators, main charge, nuclear charge