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Here’s What We Actually Know About The Amazon, Berkshire And J.P. Morgan Health Initiative (Hint: Very Little)

(MarketWatch) Feb 5, 2018 - Health experts say many have tackled rising health care costs, with limited results.

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William McGivney, PhD (Posted: February 06, 2018)

quotesOne tweet struck me in this story about the update on Amazon, JP Morgan and Berkshire and it is: • “I want there to be something to bring healthcare costs down.” Well, as a whole, general health care costs will never come down as I have written over the years. Healthcare technology innovations are always expensive. Many of these technologies turn out to be add-on interventions (monotherapy going to combination) or make more lines of therapy available by becoming first line (like anti-PD-1s and anti PD-L1s) pushing down previous first line agents to second line and then others to third line, etc. Importantly, our population of potential patients continues to get older. Actually, the most insightful comment came from Dr. Warren Buffet (honorary MD for my convenience) as the quote focused on working to “check the rise in health costs”. As such, whoever wrote the quote understands that the goal is to check or slow the rate of rise of healthcare expenditures. This is the best that we can hope for and aim for. quotes

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Thomas Marsland, MD (Posted: February 06, 2018)

quotesSo maybe they really are smarter than the rest of us and can provide better care at a lower cost. Certainly these are highly successful, powerful companies and if they really leverage their strengths and resources perhaps they will be able to accomplish their goals. I'm not sure that the "free from profit making" is going to be the answer since there still will be huge costs in providing care. They claim that with the number of employees they can develop "cost effective ways" to deliver care. Gee, the rest of us have never thought of that....Clearly cost and value are hard to define and have different meanings to different stakeholders. As we all struggle to provide more cost effective care I am struct by how much harder it is to deliver good care because of all the rules, regulations, and requirements that delay access to the care patients truly need. One step in the right direction these companies are exploring is to get rid of the hugely expensive middle man, the payer. Payers have large bloated overhead that increase cost of care tremendously. If these successful companies can bring the ability to coordinate care through more efficient information systems which they have used successfully in their other operations, perhaps this will result in a reduction in cost without loss of quality care. If their systems can eliminate many of the problems experienced by doctors and patients who struggle daily with non inter-operative, inefficient information systems, that would certainly go a long ways towards obtaining all our goals of a better health delivery system. So I guess we will find out. quotes

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