Amazon could not only open up its standard interface to other large employers, but small-and-medium sized businesses, and even individuals; in this way the Amazon Health Marketplace could aggregate by far the most demand for healthcare.
To me, that sounds like a giant Obamacare exchange without the Obama regulations. A Bezos-care exchange if you will.
Read the whole post. A major point that Thompson makes is that it takes time to disrupt an industry, particularly one that is embedded deeply into a regulatory structure.
ObamaCare tried to force insurers into frameworks. It did very little to improve coordination of care.
Amazon appears to be trying to force healthcare providers into a rational patient management framework. This would be an important step forward. There is really no management and coordination between providers now. Primary care in America is a huge failure because there is no sufficient compensation model in place to compensate primary care providers to fully engage as care managers.
Providers view patient data as their data. If Amazon can wrestle the data away from providers and manage it for patients, that would be a major step forward.
Not sure I’d agree. The ACA included significant subsidies and incentives for adoption of EHR systems as well as the formation of ACO’s in order to promote sharing of information and improve coordination of care across providers. Success has been limited. I don’t anticipate Amazon et al will do a lot better. I think where they can make a difference is on the demand side, actually.
“Success has been limited”
Its been almost completely useless.
If you read the article, any demand they direct in the marketplace will require providers to use their “interfaces”. They won’t decouple the two.
As a consumer only of Health insurance it seems like some of the benefits of a marketplace are dubious in the current environment. Switching brands for most of our purchases isn’t a big deal, but switching health insurers has been a pain more than once and the wide range of plans, deductibles, copays etc makes comparing across the market difficult. That on its own isn’t an issue, I am happy to spend a week or a month figuring out what car to buy because that should cover my car buying decisions for 5-20 years depending on circumstances. The same with buying a house, I have spent a lot of time looking at houses and working through our preferences in the last year, only to decide that staying and improving our current house is a better use of money. This is a perfectly reasonable process to go through once to figure out the house you want to live in for 10-30 years, but I would hate to have to go through it every year or two.
Has Amazon disrupted any service industries yet? Is there an Amazon Construction or Amazon College? Given that these industries are much less regulated and are made up of lots of small players they should be much easier to disrupt.
Amazon Health only makes sense if Amazon can insert itself into the Deep State and co-op it’s regulatory function towards its own ends.
Can they do what Uber and Lyft have done to taxis?
How will the gig economy work for doctors, surgeons and pharmacists? Ok, retail pharmacy could mostly be automated, but I don’t see the price of surgery changing without supply side incentives. Amazon can sell books on medicine but unless it increases the number of medical practioners the demand for care will outstrip the supply.
What I see happening is Amazon carving out an exemption for itself so it’s cost of insuring it’s young workforce is at a great discount to the average. Of course that is the game ObamaCare and Democrats wanted to stop. For who will pay the cost if healthcare for the old and infirm?
“Amazon carving out an exemption for itself”
That would be the sense in which they do what Uber did to taxis: create a service that replaces the function of taxis but is not itself a taxi service, at least not for regulatory purposes. Obamacare “without the Obama regulations”, as Arnold says. For example, maybe Amazon could create some sort of Amazon Prime Health, which is not health insurance subject to the Obama regulations, but which allows subscribers to access certain healthcare services in exchange for fixed monthly payments, which are are not insurance premiums. They could also offer individualized, customized healthcare packages using their Big Data capabilities, but packages customized for individuals would be different from insurance underwriting.
The key with Uber was to build first, ask for permission later. Once a critical mass of satisfied customers emerged, it became very difficult to regulate Uber away, at least in the US. (Anti-consumer Europe is a different story.)
Wow, you said it much better than I would have.
I’m convinced that akin to what has happened in tax and other areas of the law, even expert human beings are now incapable of giving straight answers to some basic questions regarding health care payments, that it is absolutely impossible to get such information at the ordinary customer service level necessitating the use of consultants / machers / fixers / quasi-impresarios in certain instances, and only well-designed, systematic, powerful algorithms that know all of the rules across all entities and update in real time can produce accurate predictions about billing, which is not only a positive good for consumers, but an absolutely indispensable factor in intelligent and rational management of health care provision. Amazon probably stands about as much chance as anyone in accomplishing this, which is seemingly not yet a capability of the entities in the present system.
I recently remarked to some friends that in addition to providing some undeniable positive progress, the existence of modern IT systems also increases our society’s “insanity bandwidth”, raising the tolerable threshold of institutional pathology by lowering the push-back pressure of the only constraint on this tendency, which is when the rules of the game exceed the capacity of anyone to manage no matter how much money they throw at it. We now seem to have sleepwalked into a technological catch-22 or vicious spiral where only more sophisticated technology can help us deal with the insanity enabled by the previous interation’s level of technological sophistication.
As a personal pet-peeve, every time I interact with medical service providers I am stunned how much time I waste (during the work day!) having to fill out information in inadequately small spaces on redundant paper forms via my now-slow handwriting, information which must already exist in a dozen databases somewhere, and which I cannot provide in advance by typing something on a website, and which must be entered into a computer system manually by some clerk. I’m not saying this the origin of a significant cost given today’s sky-high healthcare prices, but if Bezos can get rid of it, I’ll be grateful to him.
One could argue that you can’t disrupt an industry so deeply embedded in regulation, since it’s the intent of regulation to minimize disruption
I remain puzzled why Wal-Mart didn’t do this about five years ago. Wal-Mart owns scads of real estate that could be used for clinics.
Kaiser Industries disrupted healthcare way back when. It’s the only thing left of that company. Amazon healthcare could be Bezos’ true legacy.