Blog | Monday, February 26, 2018

3 top CEOs aim to disrupt health care

A bombshell announcement in health care came when 3 titanic corporations stated they aimed to reform health care coverage from within. Amazon, JPMorgan Chase, and Berkshire Hathaway will combine their resources, ingenuity, and mammoth leverage to bend the cost and quality curves in opposite directions. While this will undoubtedly be good news for their million or so employees, will it be good news for the rest of us? Hard to say.

Amazon inspires a range of emotions in businesses and individuals across the nation. Their economic triumph is iconic, but this success has had great costs for businesses and individuals across the country. Have you seen many small hardware stores, book shops, music shops, clothing retailers or any of the small businesses that used to be dotted across the land? If you want a closer glimpse of the culture of working at Amazon, I suggest that readers view the 2014 documentary Amazon Rising, or peruse a 2017 book called Nomadland, by Jessica Bruder, which chronicles what life is like inside Amazon's walls.

Just today, I read about an Amazon patent that can track workers' location and even what they are doing with their hands, unwelcome technology for workers who have nasty habits.

I have no doubt that these companies can fashion a health care system that would correct many of the health care system's deficiencies at large. Here's why.
• They have unlimited cash;
• They are aiming to provide coverage to employed people, and do not need to address the uninsured or unemployed;
• They have stratospheric expertise in finance and technology;
• They can exert enormous leverage over insurance companies, hospitals and the pharmaceutical companies;
• If they can track where an employee's hands are, imagine how they can track health care expenditures and outcomes and have incentives in place; and
• They are large and rich enough that they could self-insure their employees, which would whittle away administrative costs.

What is less clear is, what the effects of this disruption would be to the health care system at large. Would hospitals and insurance companies and drug companies who are excluded survive? Would medical costs on the rest of us be raised in order to offset the trio's discounts? Is their true intent, despite their denials, to become a profit center for medical care in the United States?

I thank readers who have made it this far. Those who didn't likely clicked off in search of another news morsel. I'm sure that Amazon is tracking them.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.