Since Amazon (not the other two companies) is in the data collection AND efficiency improvement business, I fully expect they will use what they learn here to eventually spin their business interests into streamlining the entire system and offering small, efficient clinics, automated diagnostics and patient services (using AI and robotics or more efficient processes) and even eventually get into a “doctor-on-demand” home service where a tele-doctor or “van” would make a drive up visit and the patient would enter to be examined or conceivably be operated on.
These things all already exist & are being used.
CVS & their minute clinics Uni hospital systems and their small community clinics tele-health screenings in RVs and vans all over the US, from rural Appalachia to under-served urban neighborhoods with vitals & imaging being automatically screened & triaged telaDoc standing in for PCPs as med students flee general medicine in droves, creating a PCP shortage pop-up sterile ORs being used around the world in places where permanent structures are not feasible
This announcement, for sure, puts household names on the ideas, but everything you mentioned already exists & is being done.
I'm talking about these things being automated, requiring fewer people in the process. This alone will save a ton of money.
so am i - we are doing it! we are, and it does require less staffing, and, especially tele-medicine, can increase the access to hyper-specialists, however other costs - vehicle, driver, highers equipment maintenance costs, etc all come into play too.
honestly, the biggest limitation to our tele-medicine work is insurers, with the biggest limit being the requirement for the MD to hold a medical license in whatever state the patient is in. (malpractice lawyers & unlimited tort awards are the most likely root-cause of this)
The root cause is a desire for people not to die from bad doctors.
There is a huge difference between routine care and preventative medicine and urgent care and significant invasive medicine.
You guys seem to think that systems like Kaiser and remote clinics that can do preventative medicine well can also handle the complex or chronic cases equally well.
Not so much as Kaiser kidney transplant patients found out in 2006. They were forced out of the UCSF and UC-Davis programs and forced to use Kaiser transplant services only. Several died that should have gotten kidneys.
How many self-insured health plans want to shell out for $500,000 liver transplants? Zero. Like in the Kaiser lawsuit where Kaiser doctors refused to authorize a MRI it’s a lot more cost effective to under-test so they can under-treat and hope the patient dies quickly.
Wait until it’s your loved one getting inadequate care.
Well, none of us are guaranteed immortality and we’ll all die of something eventually. The best medical services in the world can’t prevent that.
No, but the odds of surviving are higher with the best medical services. No one is asking for immortality but better health care than a crappy HMO that refuses to do MRIs to save money.
Still, someone must pay the bills and people who can pay the bills should receive better treatment. We live in America, not the old Soviet Union.
Since Amazon (not the other two companies) is in the data collection AND efficiency improvement business, I fully expect they will use what they learn here to eventually spin their business interests into streamlining the entire system and offering small, efficient clinics, automated diagnostics and patient services (using AI and robotics or more efficient processes) and even eventually get into a “doctor-on-demand” home service where a tele-doctor or “van” would make a drive up visit and the patient would enter to be examined or conceivably be operated on.
These things all already exist & are being used.
CVS & their minute clinics Uni hospital systems and their small community clinics tele-health screenings in RVs and vans all over the US, from rural Appalachia to under-served urban neighborhoods with vitals & imaging being automatically screened & triaged telaDoc standing in for PCPs as med students flee general medicine in droves, creating a PCP shortage pop-up sterile ORs being used around the world in places where permanent structures are not feasible
This announcement, for sure, puts household names on the ideas, but everything you mentioned already exists & is being done.
I'm talking about these things being automated, requiring fewer people in the process. This alone will save a ton of money.
so am i - we are doing it! we are, and it does require less staffing, and, especially tele-medicine, can increase the access to hyper-specialists, however other costs - vehicle, driver, highers equipment maintenance costs, etc all come into play too.
honestly, the biggest limitation to our tele-medicine work is insurers, with the biggest limit being the requirement for the MD to hold a medical license in whatever state the patient is in. (malpractice lawyers & unlimited tort awards are the most likely root-cause of this)
The root cause is a desire for people not to die from bad doctors.
There is a huge difference between routine care and preventative medicine and urgent care and significant invasive medicine.
You guys seem to think that systems like Kaiser and remote clinics that can do preventative medicine well can also handle the complex or chronic cases equally well.
Not so much as Kaiser kidney transplant patients found out in 2006. They were forced out of the UCSF and UC-Davis programs and forced to use Kaiser transplant services only. Several died that should have gotten kidneys.
How many self-insured health plans want to shell out for $500,000 liver transplants? Zero. Like in the Kaiser lawsuit where Kaiser doctors refused to authorize a MRI it’s a lot more cost effective to under-test so they can under-treat and hope the patient dies quickly.
Wait until it’s your loved one getting inadequate care.
Well, none of us are guaranteed immortality and we’ll all die of something eventually. The best medical services in the world can’t prevent that.
No, but the odds of surviving are higher with the best medical services. No one is asking for immortality but better health care than a crappy HMO that refuses to do MRIs to save money.
Still, someone must pay the bills and people who can pay the bills should receive better treatment. We live in America, not the old Soviet Union.
Which is why a regulated free market provides the best results. An unfettered free market results in abuses like company towns that only have company stores and debt slavery or dumping of hazardous wastes or poor safety or child labor, etc. Every example in history has shown this outcome when capitalism has no regulatory bounds.
Since Amazon (not the other two companies) is in the data collection AND efficiency improvement business, I fully expect they will use what they learn here to eventually spin their business interests into streamlining the entire system and offering small, efficient clinics, automated diagnostics and patient services (using AI and robotics or more efficient processes) and even eventually get into a “doctor-on-demand” home service where a tele-doctor or “van” would make a drive up visit and the patient would enter to be examined or conceivably be operated on.
These things all already exist & are being used.
CVS & their minute clinics Uni hospital systems and their small community clinics tele-health screenings in RVs and vans all over the US, from rural Appalachia to under-served urban neighborhoods with vitals & imaging being automatically screened & triaged telaDoc standing in for PCPs as med students flee general medicine in droves, creating a PCP shortage pop-up sterile ORs being used around the world in places where permanent structures are not feasible
This announcement, for sure, puts household names on the ideas, but everything you mentioned already exists & is being done.
I'm talking about these things being automated, requiring fewer people in the process. This alone will save a ton of money.
so am i - we are doing it! we are, and it does require less staffing, and, especially tele-medicine, can increase the access to hyper-specialists, however other costs - vehicle, driver, highers equipment maintenance costs, etc all come into play too.
honestly, the biggest limitation to our tele-medicine work is insurers, with the biggest limit being the requirement for the MD to hold a medical license in whatever state the patient is in. (malpractice lawyers & unlimited tort awards are the most likely root-cause of this)
The root cause is a desire for people not to die from bad doctors.
There is a huge difference between routine care and preventative medicine and urgent care and significant invasive medicine.
You guys seem to think that systems like Kaiser and remote clinics that can do preventative medicine well can also handle the complex or chronic cases equally well.
Not so much as Kaiser kidney transplant patients found out in 2006. They were forced out of the UCSF and UC-Davis programs and forced to use Kaiser transplant services only. Several died that should have gotten kidneys.
How many self-insured health plans want to shell out for $500,000 liver transplants? Zero. Like in the Kaiser lawsuit where Kaiser doctors refused to authorize a MRI it’s a lot more cost effective to under-test so they can under-treat and hope the patient dies quickly.
Wait until it’s your loved one getting inadequate care.
Well, none of us are guaranteed immortality and we’ll all die of something eventually. The best medical services in the world can’t prevent that.
No, but the odds of surviving are higher with the best medical services. No one is asking for immortality but better health care than a crappy HMO that refuses to do MRIs to save money.
Still, someone must pay the bills and people who can pay the bills should receive better treatment. We live in America, not the old Soviet Union.
Which is why a regulated free market provides the best results. An unfettered free market results in abuses like company towns that only have company stores and debt slavery or dumping of hazardous wastes or poor safety or child labor, etc. Every example in history has shown this outcome when capitalism has no regulatory bounds.
Socialized medicine simply results in mediocrity.
If a market is “regulated” it is definitionally not a free market.
And feel free to list all the “wage slave” towns in the US which keep the citizens under lock and key and prevent them from moving to a better city. I’m waiting.
Since Amazon (not the other two companies) is in the data collection AND efficiency improvement business, I fully expect they will use what they learn here to eventually spin their business interests into streamlining the entire system and offering small, efficient clinics, automated diagnostics and patient services (using AI and robotics or more efficient processes) and even eventually get into a “doctor-on-demand” home service where a tele-doctor or “van” would make a drive up visit and the patient would enter to be examined or conceivably be operated on.
These things all already exist & are being used.
CVS & their minute clinics Uni hospital systems and their small community clinics tele-health screenings in RVs and vans all over the US, from rural Appalachia to under-served urban neighborhoods with vitals & imaging being automatically screened & triaged telaDoc standing in for PCPs as med students flee general medicine in droves, creating a PCP shortage pop-up sterile ORs being used around the world in places where permanent structures are not feasible
This announcement, for sure, puts household names on the ideas, but everything you mentioned already exists & is being done.
I'm talking about these things being automated, requiring fewer people in the process. This alone will save a ton of money.
so am i - we are doing it! we are, and it does require less staffing, and, especially tele-medicine, can increase the access to hyper-specialists, however other costs - vehicle, driver, highers equipment maintenance costs, etc all come into play too.
honestly, the biggest limitation to our tele-medicine work is insurers, with the biggest limit being the requirement for the MD to hold a medical license in whatever state the patient is in. (malpractice lawyers & unlimited tort awards are the most likely root-cause of this)
The root cause is a desire for people not to die from bad doctors.
There is a huge difference between routine care and preventative medicine and urgent care and significant invasive medicine.
You guys seem to think that systems like Kaiser and remote clinics that can do preventative medicine well can also handle the complex or chronic cases equally well.
Not so much as Kaiser kidney transplant patients found out in 2006. They were forced out of the UCSF and UC-Davis programs and forced to use Kaiser transplant services only. Several died that should have gotten kidneys.
How many self-insured health plans want to shell out for $500,000 liver transplants? Zero. Like in the Kaiser lawsuit where Kaiser doctors refused to authorize a MRI it’s a lot more cost effective to under-test so they can under-treat and hope the patient dies quickly.
Wait until it’s your loved one getting inadequate care.
Well, none of us are guaranteed immortality and we’ll all die of something eventually. The best medical services in the world can’t prevent that.
No, but the odds of surviving are higher with the best medical services. No one is asking for immortality but better health care than a crappy HMO that refuses to do MRIs to save money.
Still, someone must pay the bills and people who can pay the bills should receive better treatment. We live in America, not the old Soviet Union.
Which is why a regulated free market provides the best results. An unfettered free market results in abuses like company towns that only have company stores and debt slavery or dumping of hazardous wastes or poor safety or child labor, etc. Every example in history has shown this outcome when capitalism has no regulatory bounds.
Socialized medicine simply results in mediocrity.
If a market is “regulated” it is definitionally not a free market.
And feel free to list all the “wage slave” towns in the US which keep the citizens under lock and key and prevent them from moving to a better city. I’m waiting.
They don't exist anymore because of the laws that prevent them. Same for dumping toxic chemicals into the river.
Definitionally free markets have never existed, just like true communism. Whenever you have an unregulated market you end up with price controlling monopolies or organized crime that controls the market.
Since Amazon (not the other two companies) is in the data collection AND efficiency improvement business, I fully expect they will use what they learn here to eventually spin their business interests into streamlining the entire system and offering small, efficient clinics, automated diagnostics and patient services (using AI and robotics or more efficient processes) and even eventually get into a “doctor-on-demand” home service where a tele-doctor or “van” would make a drive up visit and the patient would enter to be examined or conceivably be operated on.
These things all already exist & are being used.
CVS & their minute clinics Uni hospital systems and their small community clinics tele-health screenings in RVs and vans all over the US, from rural Appalachia to under-served urban neighborhoods with vitals & imaging being automatically screened & triaged telaDoc standing in for PCPs as med students flee general medicine in droves, creating a PCP shortage pop-up sterile ORs being used around the world in places where permanent structures are not feasible
This announcement, for sure, puts household names on the ideas, but everything you mentioned already exists & is being done.
I'm talking about these things being automated, requiring fewer people in the process. This alone will save a ton of money.
so am i - we are doing it! we are, and it does require less staffing, and, especially tele-medicine, can increase the access to hyper-specialists, however other costs - vehicle, driver, highers equipment maintenance costs, etc all come into play too.
honestly, the biggest limitation to our tele-medicine work is insurers, with the biggest limit being the requirement for the MD to hold a medical license in whatever state the patient is in. (malpractice lawyers & unlimited tort awards are the most likely root-cause of this)
The root cause is a desire for people not to die from bad doctors.
There is a huge difference between routine care and preventative medicine and urgent care and significant invasive medicine.
You guys seem to think that systems like Kaiser and remote clinics that can do preventative medicine well can also handle the complex or chronic cases equally well.
Not so much as Kaiser kidney transplant patients found out in 2006. They were forced out of the UCSF and UC-Davis programs and forced to use Kaiser transplant services only. Several died that should have gotten kidneys.
How many self-insured health plans want to shell out for $500,000 liver transplants? Zero. Like in the Kaiser lawsuit where Kaiser doctors refused to authorize a MRI it’s a lot more cost effective to under-test so they can under-treat and hope the patient dies quickly.
Wait until it’s your loved one getting inadequate care.
Well, none of us are guaranteed immortality and we’ll all die of something eventually. The best medical services in the world can’t prevent that.
No, but the odds of surviving are higher with the best medical services. No one is asking for immortality but better health care than a crappy HMO that refuses to do MRIs to save money.
Still, someone must pay the bills and people who can pay the bills should receive better treatment. We live in America, not the old Soviet Union.
Which is why a regulated free market provides the best results. An unfettered free market results in abuses like company towns that only have company stores and debt slavery or dumping of hazardous wastes or poor safety or child labor, etc. Every example in history has shown this outcome when capitalism has no regulatory bounds.
Socialized medicine simply results in mediocrity.
You worried about amazon... HAHAHAHAHAHAHAHA... you don't understand Big Insurance.... they already have ALL THE DATA.
IF this were a free market... it isn't.
I would posit that this medicine market basically parallels the android free-market model, and you're get tinga race to the bottom for a global quality measure, and in the end, to pay for what you want, you end up buying either SamSung or Apple anyway.
Especially where the cost model is managed by a 4th party (big insurance) for a 3rd party (the employer), and not the patient (quality is measure in cost per employee, not quality of life). [this is the equivalent of fleet purchases [think carriers] for corporate buyers [your android phone at work is delivered because your boss thought it 'did smartphoning good enough' == the basic health payment system in the world]
My simple answer is: Make it illegal to sell health insurance to 'groups,' and make every insurance company include every healthcare provider in their network, and make every insurance company support a std claim form, and require common medical record [portability] to be offered to each patient. employers/banks must offer HSA savings plans to anyone. Any money that passes through an HSA to an insurance company/care-provider is tax free to the individual.
Read: let doctors be doctors, patients be patients (and manage their money), and insurance companies provide real pool based insurance.
Disclaimer: I've worked for 1 doctor at one point, and 2,500 doctors for several year, a fortune 50 'health benefits provider', been a Startup HR benefits coordinator, dealt with an 'out of network*' 3 year Cancer episode, and the brother of an elected state legislator official whose committee oversaw Medicaid in the state.
*Because I knew what 'in-network quality' measures were (they accepted a higher discount), and fought their argument that OON = lower quality. 5 appeal letters a month, but it worked.
My simpler answer: Give everyone who works or has passive income(pays income tax) medicare and a $0 deductible, and expand medicare tax passive income Let doctors that don't want to accept medicare be out of network, and people fund HSAs to self-insure.
Again, get employers out of business of controlling healthcare market through insurance companies. They are the problem... nothing else.
Comments
Socialized medicine simply results in mediocrity.
And feel free to list all the “wage slave” towns in the US which keep the citizens under lock and key and prevent them from moving to a better city. I’m waiting.
Definitionally free markets have never existed, just like true communism. Whenever you have an unregulated market you end up with price controlling monopolies or organized crime that controls the market.
IF this were a free market... it isn't.
I would posit that this medicine market basically parallels the android free-market model, and you're get tinga race to the bottom for a global quality measure, and in the end, to pay for what you want, you end up buying either SamSung or Apple anyway.
Especially where the cost model is managed by a 4th party (big insurance) for a 3rd party (the employer), and not the patient (quality is measure in cost per employee, not quality of life). [this is the equivalent of fleet purchases [think carriers] for corporate buyers [your android phone at work is delivered because your boss thought it 'did smartphoning good enough' == the basic health payment system in the world]
My simple answer is: Make it illegal to sell health insurance to 'groups,' and make every insurance company include every healthcare provider in their network, and make every insurance company support a std claim form, and require common medical record [portability] to be offered to each patient. employers/banks must offer HSA savings plans to anyone. Any money that passes through an HSA to an insurance company/care-provider is tax free to the individual.
Read: let doctors be doctors, patients be patients (and manage their money), and insurance companies provide real pool based insurance.
Disclaimer: I've worked for 1 doctor at one point, and 2,500 doctors for several year, a fortune 50 'health benefits provider', been a Startup HR benefits coordinator, dealt with an 'out of network*' 3 year Cancer episode, and the brother of an elected state legislator official whose committee oversaw Medicaid in the state.
*Because I knew what 'in-network quality' measures were (they accepted a higher discount), and fought their argument that OON = lower quality.
5 appeal letters a month, but it worked.
My simpler answer: Give everyone who works or has passive income(pays income tax) medicare and a $0 deductible, and expand medicare tax passive income Let doctors that don't want to accept medicare be out of network, and people fund HSAs to self-insure.
Again, get employers out of business of controlling healthcare market through insurance companies. They are the problem... nothing else.