
An open letter to Jeff Bezos: You are needed to disrupt health care - SQL2219
https://qz.com/1090762/an-open-letter-to-jeff-bezos-you-are-needed-to-disrupt-the-health-care-sector/
======
SapphireSun
Bezos will read this and think, whatever happened to Google Health? Anyways,
the health care system in this country is intentionally fucked up on a policy
basis. Private industry mostly extracts pounds of flesh and puts bandaids on
it. We need public policy to fix it.

Also, holy shit this is a brain disease: "Congress enacted a law that bans
Medicare from negotiating drug prices with the pharmaceutical industry.
However, since Amazon Health would act as a private corporation dealing with
other private corporations, it is hard to imagine Congress could prevent it
from getting favorable prices for its patients."

Great. Instead of fixing public policy for the benefit of the public, create a
monstrous new private entity that sucks blood money from the public.

~~~
SapphireSun
I also would like to point out how insane it is that the author of this piece
is crying out for a Nietzschesqe superman to save the public from itself.
Mutual aid and the democratic process are quite enough. Just a hint though,
solving some of our problems will take some redistribution of wealth, though
in the case of medicine universal health care will save an ungodly amount of
money which will make things easier.

~~~
closeparen
>the democratic process

The will of the people is clear: illness ought to be ruinously expensive,
health insurance ought to be a privilege for those who can afford it. The
democratic process has considered the issue quite seriously, several times in
recent years, and decided on the present situation. There is overwhelming
bipartisan support for keeping healthcare pretty much as is, with very slight
variations between red and blue.

Barring a major change in public opinion, any improvement in healthcare will
have to be undemocratic.

~~~
mercer
> The will of the people is clear

I thought quite a lot of research showed that voters across the board are
actually in favor of more Europe-style/better health care policies, but that
they vote against their own interests because of partisan issues/politics.

If that's true, you might still be right in practice of course, but at the
very least there's a bit more hope that things can change.

~~~
craftyguy
And yet here we are..

~~~
lkrubner
In a country where a law that is only supported by 17% of the public easily
gets through the House and only fails in the Senate by a single vote.

------
pcurve
Amazon has been looking into healthcare space for awhile, including pharmacy
benefit manager. The trouble is, healthcare space is extremely regulated and
entry barrier is very high. It takes inordinate amount of industry knowledge
to get your foot in the door and the only realistic way to enter is through
acquisitions

Even then, Amazon is completely dwarfed compared to all the players in the
sector; pharma, hospital systems, chain pharmacies, indie pharmacies, long
term care facilities, drug distributors, health insurance, TPAs, PSAOs,
medical instrument makers, DME makers, all with their own agendas.

Regarding the pharmacy missing drug interaction problem cited in the article.
It isn't due to lack of sophisticated system or lack of data. Far from it.
Healthcare entities sit on colossal amount of data. The issue is fragmentation
and lack of centralized mechanism that prevents effective communication and
sharing of data. That's a regulatory and policy problems, not innovation
problem.

Believe me, I want this problem fixed too, but Amazon isn't going to be the
one to solve it.

------
hannob
This sentence is eye-opening:

> No wonder we pay more for health care and get poorer outcomes than any other
> industrialized nation.

Ok, we figured out that healthcare works better in other countries. So what
could we do? Maybe look how other countries are doing it and try to do
something alike? But that would be too easy, right? So better ask some
billionaire to fix it for us.

~~~
collyw
We are all commie socialists in Europe, thats why. It's like a dirty word in
the USA.

------
zaptheimpaler
> Health care is a huge sector of the economy, comprising close to 18% of US
> GDP

This is why health care is hard to change. 1/5th of the economy is in the
current system. Systems that big are going to be hard and slow to change -
some inertia, some corruption. The revenue of "McKesson Corporation" (one of
the highest in healthcare) is single-handedly(!) 1% of US GDP. Imagine how
much power those guys have. They must have shaped the entire country (laws,
regulations, public opinion) to an extent with that big a share.

------
jackvalentine
Oh god, please no.

If America 'fixes' it's healthcare with an billionare's 'disruption' power
play the pressure on the rest of the world with functioning social healthcare
systems to dismantle them will reach a sickening crescendo.

We're already in many ways pulling it apart, even with the less than stellar
lesson of the USA to learn from...

(Australia, for reference.)

~~~
lovich
Is anyone in the western world that's not leaning conservative looking to
dismantle their healthcare system? Australia and the UK are, but from what I
know ow the been infected by the US's ideology of thinking that private
corporations can do no wrong by definitjon. The rest of the west though, EU
and Canada, aren't trying to dismantle their healthcare.

~~~
lucaspiller
One of the issues in the UK that is pushing these changes through is wait
times and understaffing. Unless you have an emergency or something life-and-
death serious you might as well forget about it. The people don’t like it and
wanted change, which is why the Torries and Brexit was voted for.

My mother was recommended to visit the hospital by an optician for a more in-
depth check related to glaucoma. She ended up having to wait 9 months for her
appointment...

I don’t think the general public want to see it privatised though, it’s just
the governments are pushing it through as their agenda to avoid having to
raise taxes (corporate and income tax in the UK is on the low side compared to
other Western-European countries).

~~~
DanBC
GP asked

> Is anyone in the western world that's not leaning conservative looking to
> dismantle their healthcare system?

It's important to be honest about this: the conservative party have made the
decision to de-fund the NHS and in real terms they've considerably cut funding
for the NHS. This is even more true when you look at the changes to the NHS
and the collapse in social care.

the changes were splitting out public health (eg, sexual health, drug and
alcohol rehab, suicide prevention) to local authorities. Collapse in social
care was caused by defunding LAs.

~~~
lovich
That's a tried and true method from any group that wants to get rid of some
system and then gets in charge of said system. Just make it impossible for it
to succeed, for instance by decreasing their funding or adding onerous
beuracracy that makes everything run slower. After that you can just point to
how the system is running poorly as an excuse for dismantling it

------
Feniks
Actually if the US wanted they could copy paste the Dutch healthcare system
right now. It's better and cheaper, though not free.

But this is an ideological problem, nobody wants to pay up. Things like income
equality and social justice aren't things most Americans care about. I don't
mean that as criticism. The US is just different.

------
fiokoden
Hey an open letter. Instant credibility and gravitas.

Really all communication should be open letters, so much more would be taken
seriously, and so much more stuff done.

------
spraak
I just recently after moving back to the US had to sign up for an ACA plan.
For my family I pay about $250/month only to find that our annual deductible
is over $9000, meaning I have to spend an additional $750/month on health care
just to for the insurance to pay 40% of the bill. I need to find a new
solution or we'd just need to resign ourselves to never seeing the doctor.

~~~
SapphireSun
Where did you move from? I'm sorry you have to be subjected to our "heath
care" system that essentially functions as a machine that draws money from the
arms of the well to do and turns the poor into blood.

~~~
spraak
Great analogy! We were living in Thailand and we luckily just paid for care
when we needed it, which for us was very affordable.

------
mhkool
The health system is not working: diabetes has officially no cure but hundreds
of doctors cure it. A senator has brain cancer but nobody points him to an
expert who cures brain cancer for 20+ years (see the clinic of Dr Burzynsky),
low energy, headaches, ADD, ADHD, arthritis and many more diseases are being
cured for many years. Alzheimers can now be cured (See Dr dale Bredesen's
work) and I can go on.

The health system continues to be in a bad state if Bezos will try to do the
same thing cheaper. If Bezos is smart he will have a chat with Dr Mark Hyman
on how to introduce functional medicine to the whole country. It is cheaper
and ... it works!

------
partycoder
A $1 bag of water (sterile saline solution) in the American healthcare system
costs hundreds of dollars.

------
collyw
You don't need Bezos to disrupt it. Just copy what Europe does.

------
squozzer
If I were him, I would take a pass. No reason to "accidentally" die on an
operating table. Let the imminent revolution handle the problem!

------
dave333
HMOs like Kaiser Permanente already achieve large savings and reduction in
paperwork and copays vs fee for service health insurance.

------
midnitewarrior
Bezos is too smart to enter a market with such high regulatory risk.

------
Dowwie
There's more of a people and policy problem than there is money

------
iancmceachern
I'll disrupt it for you (us), just need the seed funding.

------
musage
What is his "vision" then?

------
antibland
"Alexa... I'm having a h-heart attack." "Got it. The temperature is sixty-
eight degrees."

