Peter Kongstvedt on the Amazon Healthmarket, Coming Soon to an Alexa Near You

By Clive Riddle, March 2, 2018

Lendedu released survey results this week on consumer acceptance if Amazon ventured into several financial related markets including virtual currency, banking, lending, investment and insurance. Their survey involved polling 1,000 consumers who purchased something from Amazon within that past 30 days.

In the insurance arena, consumers were asked about Life, auto and health insurance: “If offered, would you be open to the idea of using the listed insurance product created by Amazon?” For health insurance, 35.8% said yes, 31.3% said no and 32.9% were unsure. 41.6% of the consumers who were Amazon Prime users said yes. Acceptance for auto insurance was nine percentage points higher and life insurance was two percentage points higher.

Just over a month ago, most everyone in the healthcare universe got excited or at least paid notice when AmazonBershireJPMorgan healthcare was announced. Of course some such as Sam Baker cautioned in Axios that “We don't know what they're even trying to do” and that “other big companies have tried something similar.”

A month later AmazonBershireJPMorgan healthcareis still a blank canvas that we’re allowed to paint our own perceptions into. Healthcare media reported on the Lendedu survey results with headlines such as 35.8% of Americans would use an Amazon health insurance plan.

The national treasure of healthcare wit and expertise that is Peter Kongstvedt, MD FACP had this to say in response (including footnotes) to these headlines:

“Who wouldn’t be eager to sign up for an undescribed health plan, for which we can imagine it to be low-cost, super-convenient, available through Alexa, delivered in your home by the same day, and come with unlimited music and video streaming?* Few if any barriers to achieving this. Merely need to tell hospitals, physicians, and drug manufacturers what they will accept as payment in full and their obligation to meet Just-in-Time delivery, and they will all fall all over themselves to be in the Amazon HealthMarket.® ”

* PrimeHealth® 12-month subscription required, renewable at PrimeHealth’s sole discretion. Treatment options and bandwidth limitations may apply. Offer only available in U.S. states and territories. Acceptance denotes consent with all EULA Terms and Conditions including your Blood oath to forever abandon WalMart® and Apple® iTunes®.


Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

By Claire Thayer, March 2, 2018

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Congress Races The Clock In Quest To Bring Stability To Individual Insurance Market

Congress is running out of time if members want to come up with legislation to stabilize the individual insurance market.

Kaiser Health News
Friday, March 2, 2018

Sessions to DEA: Evaluate opioid production quota

Attorney General Jeff Sessions is asking the Drug Enforcement Administration (DEA) to evaluate whether changes are needed to the amount of opioids drug makers are allowed to produce.

The Hill
Thursday, March 1, 2018

Collective Health Bets Employers Are Fed Up With Health Expenses

Collective Health Inc., a startup offering tech-savvy tools for managing health benefits, has raised a fresh infusion of investor cash as it seeks to win over more employers fed up with a fragmented, costly market

Wednesday, February 28, 2018

Apple is launching medical clinics to deliver the 'world's best health care experience' to its employees

Apple is launching a group of health clinics called AC Wellness for its employees and their families this spring, according to several sources familiar with the company's plans.

Tuesday, February 27, 2018

Senators unveil bipartisan bill to fight opioid epidemic

A bipartisan group of senators is introducing legislation Tuesday to address the opioid epidemic, framing it as a follow-up bill to the Comprehensive Addiction and Recovery Act (CARA) signed into law in 2016.

The Hill
Tuesday, February 27, 2018

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.


The State of the Uninsured and Health Insurance Coverage

The State of the Uninsured and Health Insurance Coverage

by Clive Riddle, February 23, 2018


The National Center for Health Statistics has just released updated health insurance coverage estimates from selected states using 2017 National Health Interview Survey data.  Here are seven things to know about their findings for the first 9 months of 2017:


1.     28.9 million (9.0%) persons of all ages were uninsured, not significantly different from 2016, but 19.7 million fewer persons than in 2010.

2.     12.7% of adults aged 18–64, were uninsured, 19.5% had public coverage, and 69.3% had private health insurance coverage.

3.     4.4%  of adults aged 18–64 (8.6 million) covered by private health insurance plans obtained their coverage through the federal or state-based exchanges.

4.     Adults aged 25–34 were almost twice as likely as adults aged 45–64 to lack health insurance coverage (17.3% compared with 9.2%)

5.     4.9%  of children aged 0–17 years, were uninsured, 41.9% had public coverage, and 54.6% had private health insurance coverage.

6.     The percentage uninsured decreased significantly for all age groups from 2013 through the first 9 months of 2017, ranging from –6.2 percentage points for ages 45–64 to –10.7 percentage points for ages 18–24.

7.     43.2% of persons under age 65 with private health insurance were enrolled in a high-deductible health plan (HDHP) compared to 39.4% in 2016


However, as a warning sign that 2018 may see slippage in these insurance coverage, the Minnesota Department of Health just issued an ominous press release, indicating that “last year Minnesota saw one of its largest, one-time increases in the rate of people without health insurance since 2001. The uninsured rate rose from 4.3 percent in 2015 to 6.3 percent, leaving approximately 349,000 Minnesotans without coverage.”

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:


Ten ERs In Colorado Tried To Curtail Opioids And Did Better Than Expected

One of the most common reasons patients head to an emergency room is pain. In response, doctors may try something simple at first, like ibuprofen or acetaminophen. If that wasn’t effective, the second line of defense has been the big guns.

Kaiser Health News

Friday, February 23, 2018

Evaluations Of Medicaid Experiments By States, CMS Are Weak, GAO Says

With federal spending on Medicaid experiments soaring in recent years, a congressional watchdog said state and federal governments fail to adequately evaluate if the efforts improve care and save money.

Kaiser Health News

Friday, February 23, 2018

HHS deletes budget request for $11.5 billion in risk-corridor funding

The HHS walked back a request for more than $11.5 billion to fund the Affordable Care Act's risk-corridor program after health insurers suing for those payments said the budget item strengthened their cases.

Modern Healthcare

Thursday, February 22, 2018

Advocacy groups say better data sharing, consistent privacy laws will help control opioid prescribing

A wide array of technology can help limit the impact of the opioid epidemic, according to the College of Healthcare Information Management Executives (CHIME), but only if certain policy changes address long-standing concerns like patient matching and telehealth reimbursement.

Fierce Healthcare

Wednesday, February 21, 2018

Trump proposal boosts skimpy insurance plans, again undercutting Obamacare

The Trump administration is proposing to expand the availability of short-term health insurance plans that some deride as “junk insurance” — an effort that could give consumers cheaper coverage options but undermine Obamacare's marketplaces and popular protections for pre-existing medical conditions.


Tuesday, February 20, 2018


These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.


It's About Time

It's About Time

By Kim Bellard, February 16, 2018


Chances are, the sun isn't directly overhead for you when it is for me.  That's why for most of human existence time was a local matter.

Nowadays, we have time zones that span the globe, and we have clocks so accurate that satellites have to 
take into account relativistic time-dilation effects. Technology made the change possible, and necessary. 

Health care should learn from this.


It used to be that local time was good enough.  The village clock served your purposes.  It was the railroads that made this impractical.  People wanted to know when trains would arrive, and when they'd leave.  More importantly, if they weren't coordinated, trains traveling in different directions might -- and did -- run into each other.

We treat health care much like we used to treat time. That is, it is largely local.  How it is practiced in one community may not be how it is practiced in the next community, or even the next hospital or physician practice within a community. . 

The care you get will depend on, of course, what is wrong with you, but also on 
which physician you see.  Very few dispute that there is significant variation in care, or that it is probably bigger than it should be.  But there's not much evidence that it is getting any less. 

We accept these variations because, well, that's how it has always been.  We accept them because we think our personal situation is unique.  We accept them because we trust our local experts.   

We accept them for all the same reasons we used to accept that time should be local. Technology has made it both necessary and possible that we move away from this attitude.

It is necessary because the scope of the problem is clear.  As Propublica put it in a 
recent expose of unnecessary procedures: "Wasted spending isn’t hard to find once researchers — and reporters — look for it." 


Almost twenty years ago the Institute of Medicine estimated as many as 98,000 hospital deaths annually due to medical errors.   More recently, medical errors have been estimated to be the third leading cause of death in the U.S. 

Yes, moving away from "local" health care is necessary.

The good news is that it is possible.  We have the technology to consult with physicians who don't happen to be local, such as through telemedicine.  It is possible to get the "best" doctor for our needs, not just the closest. We have artificial intelligence that can analyze all that data plus all those medical studies that no human can possibly keep up with.  It is possible to come up with the "right" recommendations for us.   

We have to stop thinking of health care as local.  The information it is based on is not.  The people who are best able to apply that information to our situation may not be.

If I get a driver's license, I don't have to get another one when I drive to another state.  If I get on a plane, the pilot doesn't have to have a pilot's license from each state he/she lands in, or flies over.  But if I want to use a doctor who is in a different state (or country), that doctor needs a license from my state.    

We've always justified such licensing by states wanting to ensure the safety of their citizens, but drivers and pilots can put those citizens at risk too.  It's not really about risk; it's 
more about controlling competition

There is irrefutable evidence that local health care is rarely what is going to be best.  It might not be bad care, but most likely it's only going to be average. 

Maybe we're willing to settle for that.  I'm not.

Time for a change.


This post is an abridged version of the posting in Kim Bellard’s blogsite. Click here to read the full posting