Author Topic: BRK/JPM/AMZN healthcare tie up  (Read 13157 times)

globalfinancepartners

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Re: BRK/JPM/AMZN healthcare tie up
« Reply #40 on: June 21, 2018, 06:55:03 AM »
You made $21/ hour pretax as an attorney??!  Yikes!


sleepydragon

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Re: BRK/JPM/AMZN healthcare tie up
« Reply #41 on: June 21, 2018, 07:05:24 AM »
You made $21/ hour pretax as an attorney??!  Yikes!

Maybe a real estate attorney? :)

CorpRaider

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Re: BRK/JPM/AMZN healthcare tie up
« Reply #42 on: June 21, 2018, 07:10:58 AM »
He was a first year at Cravath...but he said hourly.   ;D

DTEJD1997

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Re: BRK/JPM/AMZN healthcare tie up
« Reply #43 on: June 21, 2018, 07:16:12 AM »
You made $21/ hour pretax as an attorney??!  Yikes!

Maybe a real estate attorney? :)

No, I was a "contract attorney" brought in to work on massive lawsuits.  It was preparation/sorting/analysis of documents.

At that point in time (2015), there were attorneys POUNDING down the door to get in...

A lot of attorneys did that work "for the big kash money!".  I was surprised and dismayed at that.  it was then explained to me that $21 an hour was SUBSTANTIALLY more than a lot of attorneys make in the Detroit market. 

Thankfully, I don't do that any more.  I feel bad for the people who still do.

It was boring, tedious work.  It was the best outcome a LOT of people could hope for though.

I could tell so many crazy/sad stories...

mbreject

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Re: BRK/JPM/AMZN healthcare tie up
« Reply #44 on: June 21, 2018, 10:26:03 AM »
$27k is actually pretty good for a family.

My parents paid ~$35k a year (PPO, California) before my dad got Medicare. My mom's counting the days until she's 65 lol
I think free health insurance for the unemployed is why a lot of people are unhappy about Obamacare. People like my parents saw a lot of their friends quitting their jobs to travel and getting free insurance while the people who kept their jobs had to keep paying for this crazy thing.

Also, I'm pretty sure a lot of people think insurance is cheaper than it really is, because their employer subsidizes it.

I'm very hopeful about this new company and hope they open it up to other people as well.

Good points.

Concerning self-insured firms and the captive market, a practical experience (read from the scientific journal USA Today):
"As the founder and CEO of a mid-sized company that employs 180 people in the United States, I know this well. In 2018, we will pay $2.8 million to insure our workers and their families. Year after year, we have wrestled with the costs of our health care plans. And despite trying every trick in the book, our per-employee costs have tripled over the past 14 years. A family plan in 2018 will cost us $27,000, which is higher than the annual salary of one-third of all working Americans. To put it another way, we are paying $13.50 per hour per employee just to cover the health care benefit. Itís a model thatís completely unsustainable, and needs to change."


A family insurance plan costs $27k per year? 

That could almost be the wage for an employee per year!  When I was working as an attorney a couple years ago, the pay rate was $21/hour.  Something has gotten seriously, seriously out of whack.  A lot of people in America (not just fast food workers & clerks) just simply can't afford to pay that...not even close.

Cigarbutt

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Re: BRK/JPM/AMZN healthcare tie up
« Reply #45 on: October 17, 2018, 10:28:06 AM »
The venture is shaping up.
I understand that the recently posted "data scientist" position may have something to do with the adventure.
https://www.amazon.jobs/en/jobs/715945/data-scientist-healthcare-benefits

FWIW, I think there is a huge talent basin for this position.
The profile requires to be data driven, transformative and multi-disciplinary.

The #1 candidate on my list is Mr. Andrew Bartley.
https://itpeernetwork.intel.com/lean-startup-approach-predictive-clinical-analytics-healthcare-part-ii/
https://www.intel.com/content/www/us/en/healthcare-it/solutions/documents/predictive-analytics-in-healthcare.html

Was looking recently at work being done on workers injuring themselves at work and ending in the downard spiral of an opioid addiction problem. Big issue, huge costs (human and financial) and...mostly preventable. All you need is a relatively intelligent tool that would spot the risk factors early on, provide alternatives and remedial actions before it's too late. And it would cost less too.

An unrecognized concept is that the approach that the data scientist will apply is very similar to what clinicians do on the field.
They will:
-observe and collect data (listen, ask, examine and read test results)
-try to answer a question (diagnosis)
-finds way to predict what will happen based on the above two (risk factors and natural history)
-try to prescribe a solution in order to obtain a positive change in outcome

Hippocrates would be proud and advanced analytics is closer than you think.

handycap5

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Re: BRK/JPM/AMZN healthcare tie up
« Reply #46 on: October 17, 2018, 12:39:14 PM »
Hippocrates would be proud and advanced analytics is closer than you think.

Shane Parrish did a very interesting interview with Atul which I recommend.

Also, since you mentioned the Hippocratic Oath, I can't help but think of Milton Friedman's criticism of the same (search for Oath here: http://www.freerepublic.com/focus/f-news/1684832/posts). I suspect the greater opportunity and greater challenge will be changing human behavior and organizations, not mining data. But maybe the latter can aid the former.

Cigarbutt

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Re: BRK/JPM/AMZN healthcare tie up
« Reply #47 on: October 17, 2018, 06:38:45 PM »
Shane Parrish did a very interesting interview with Atul which I recommend.

Also, since you mentioned the Hippocratic Oath, I can't help but think of Milton Friedman's criticism of the same (search for Oath here: http://www.freerepublic.com/focus/f-news/1684832/posts). I suspect the greater opportunity and greater challenge will be changing human behavior and organizations, not mining data. But maybe the latter can aid the former.

Thank you for the link handycap5. It was an interesting conversation and I hope that the BRK-led venture amounts to something.

Mr. Gawande is a humble leader with conviction and I guess he is not the type to underestimate the challenge.

Benjamin Friedman must himself turn in his grave if he sees the growing portion of GDP spent on healthcare and he did make a distinction between the oath and the man behind the oath. Going forward, we will need to continuously rebalance the tensions between the freedom for alternatives and the reliance on third party payments.

The foreseeable future is fuzzy, as always, but I think health outcomes, for at least a while for the tapeworm to grow, will come down to a race between growing "system" productivity and diminishing returns on "scientific" inputs. All the hype around the big data and predictive analytics is really about gradual and evolutionary application of method where science meets humanity.

Interesting to note that Mr. Gawande does not talk about increasing intricacies and opacity, he explains that we will try to "unknot the complexity". In my own humble on-the-ground experience, the most effective improvement projects were simple, automatic and "natural", irrespective of the degree of underlying complexity, insight or sophistication. The underlying design will continue to require human intelligence but the application of the design will increasingly require the assistance of artificial intelligence.

Concerning incentives and changing people, I remember an episode where I was part of a group responsible, in a self-regulating type of environment, for adjustments in payment amounts (code) for listed procedures. There was a typing mistake and a rarely performed procedure became more rewarding financially. Guess what happened after the new list was disseminated. People, medical or otherwise, respond to incentives, good and bad.

Concerning changing people and systems, nobody likes it to be told about the huge gap that exists between the assumed "performance" and actual results but Mr. Gawande sees himself as a bridge builder and Fortune favored the prepared mind. A relevant example is the integration of the thermometer into the "system". Historical example but highly enlightening. Just like the BRK-led projects to come, the iniatives may first be seen as threats but, before you know it, it's not the the people that will change the system but the system that will change the people.
https://blogs.scientificamerican.com/observations/why-doctors-reject-tools-that-make-their-jobs-easier/

I'm long human intelligence since ignorance has reached the level of ineptitude.
« Last Edit: October 17, 2018, 06:42:28 PM by Cigarbutt »

Jurgis

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Re: BRK/JPM/AMZN healthcare tie up
« Reply #48 on: October 17, 2018, 09:24:56 PM »
I'm long human intelligence since ignorance has reached the level of ineptitude.

OT.

I'd be long Elon Musk's Neuralink, since human intelligence and knowledge acquisition in particular seem to be hitting walls dealing with complex multifaceted problems.

Although I continue to be amazed by new discoveries, especially in math and physics where problems and their solutions have moved beyond being understandable by very very few.
"Before you can be rich, you must be poor." - Nef Anyo
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globalfinancepartners

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Re: BRK/JPM/AMZN healthcare tie up
« Reply #49 on: October 18, 2018, 07:48:56 AM »
Not sure where to link this, but Warren did an event sponsored by newly acquired MLMIC, New York's largest medical malpractice insurer - where he had a public conversation with Dr. James Reed, CEO of St. Peter's Health Partners.  (if you've reached your 'free limit' for reading the article, open the link in private or incognito mode to read)

https://www.bizjournals.com/albany/news/2018/10/18/warren-buffett-health-care-st-peters-reed.html