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標題: 亞馬遜、波克夏、JP摩根共組公司進軍醫保業 [打印本頁]

作者: mikeon88    時間: 2018-1-30 20:51     標題: 亞馬遜、波克夏、JP摩根共組公司進軍醫保業

Amazon, Berkshire Hathaway and JPMorgan have agreed to create an independent company focused on technology solutions aimed at providing U.S. employees and their families simplified, high-quality, transparent healthcare at a reasonable cost.
• The initial formulation of the company will be led by Berkshire investment officer Todd Combs, JPMorgan Chase Managing Director Marvelle Sullivan and Amazon SVP Beth Galetti.
• Healthcare providers/insurers are down premarket on the news: (NYSE:UNH) (-2%); (NYSE:ANTM) (-2%); (NYSE:AET) (-3%); (NYSE:CNC) (-2%); (NYSE:MOH) (-2%); (NYSE:CVS) (-7%).
• ETFs: GRX, THW, BME, IXJ
作者: mikeon88    時間: 2018-1-30 20:53

救郎喔∼∼今晚我的淨值重創
作者: Curry    時間: 2018-1-30 20:54

Mike大的UNH中槍了...
作者: chousirbuy    時間: 2018-1-30 23:30

剛才開盤還很好奇為什麼我的美國醫院公司大漲 8%然後去查醫藥股全躺下
原來是這樣, 但是我還是搞不懂醫保公司會對這些公司有什麼影響?
作者: Raimu    時間: 2018-1-31 00:10

HCA 盤中一度大漲9%懶得去研究為什麼…
作者: mikeon88    時間: 2018-1-31 07:01

In a tweet, CNBC's Meg Tirrell reports that Express Scripts (ESRX -4.2%) "looks forward to hearing more" about the Amazon/Berkshire/JPMorgan healthcare venture aimed at simplified affordable healthcare.
• Express says it has reduced costs by $32B in the past year alone related to the management of chronic conditions like diabetes and heart disease, adding that it would like to hear how "we can work together to improve healthcare for everyone."
作者: mikeon88    時間: 2018-1-31 08:37



作者: mikeon88    時間: 2018-1-31 13:35

美國分析師都質疑這三巨頭可以讓藥價會降得下來?
我也是。
聲明中說這家新公司是非營利事業,
三巨頭願意永遠承擔虧損的風險?而且可能是巨額虧損!

藥廠、藥房、醫保之所以有高低不一利潤率是因為要承擔大小不同風險,
把利潤降低了,供給就減少,如此更非患者之福。
供需是經濟運作的基本道理,老巴應很懂才對。
作者: duwa    時間: 2018-2-1 11:53

新藥假如效果勝出價格無法下降,而且還會更高。
但是其他競爭藥(新藥)價格會被砍或是也有市場利基就維持價格的結果也無法使整體藥價下降。
生物相似藥(大分子)價格會被影響,但是生物新藥的開發沒有那麼快,所以這邊藥價也省不了多少。
學名藥(小分子)價格就慘了,這三巨頭就是要吃這一塊,所以可能競爭的醫保(例如UNH vs 波克夏)+可能競爭的信貸(例如現在藥房的信用卡業務 vs JPM)+可能競爭的物流(例如CVS vs AMZN)就會受到影響,但是三巨頭也沒辦法一跳下來就全吃,更何況三巨頭利益不一定一致,未來很不確定,說不定只是政策背書...
作者: mikeon88    時間: 2018-2-1 12:43

通路的利潤率是低的,ESRX 3Q7 營利率才6%不到,
藥價高也不是它造成的,
亞馬遜老是以此為藉口想進軍藥品通路業。

UNH 4Q17 營利率8%不到

AMZN 3Q17 營利率 1%不到

作者: duwa    時間: 2018-2-1 16:33

我猜AMZN不是真的想賺通路的辛苦錢,只是藉由策略聯盟切入市場拿到病患的用藥數據整合自己的線上行銷系統跟最近新併購的有機超市Whole foods,然後再炒股價。AMZN從來都不是賺錢來提升股價,都是炒未來提升股價,然後再拿自己炒高的股價去買別人辛苦經營的公司。
作者: mikeon88    時間: 2018-2-1 17:24

亞馬遜越賺越少,股價越吹越高,
美國投資人不曉得在想什麼?
去開藥品通路不怕初期會虧損嗎?


作者: mikeon88    時間: 2018-2-1 19:07

亞馬遜應回去好好整頓Whole Food,入主之後管理上出了大問題。
亞馬遜用管理雜貨Just-in-time的方式在管理食物類存貨,造成Whole Food 架上大缺貨

'Seeing someone cry at work is becoming normal': Employees say Whole Foods is using 'scorecards' to punish them

Whole Foods uses checklists called "scorecards" and tests called "walks" to ensure stores comply with a new inventory-management system.
Employees say the system has crushed morale and led to widespread food shortages.
"The stress has created such a tense working environment," a supervisor at a West Coast Whole Foods store said. "Seeing someone cry at work is becoming normal."
Many employees at both the corporate and the store levels don't understand how OTS works, employees said.



作者: chousirbuy    時間: 2018-2-1 22:17

我很直覺的就想到以後可以在亞馬遜上用很方便的方式和老巴簽保單,而且可以從JP銀行自動扣款然後保單組合自己決定,不用請人,不需要房地產
接著亞馬遜再用很利害的數學程式教人如何自己選保險組合, 順便取代經銷商去和藥廠談價錢
但又不知道會不會掛掉,所以先從自己員工開始


反正這塊這麼大, 不滿意現狀的民眾又那麼多, 那怕有一點點效果, 都是正面的
以後老巴股東會上, 桌上會放可樂和藥....




[ 本帖最後由 chousirbuy 於 2018-2-1 22:18 編輯 ]
作者: chousirbuy    時間: 2018-2-1 22:28

https://zh.wikipedia.org/wiki/2017%E5%B9%B4%E7%BE%8E%E5%9B%BD%E4%BF%9D%E5%81%A5%E6%B3%95%E6%A1%88]https://zh.wikipedia.org/wiki/2017%E5%B9%B4%E7%BE%8E%E5%9B%BD%E4%BF%9D%E5%81%A5%E6%B3%95%E6%A1%88]https://zh.wikipedia.org/wiki/2017%E5%B9%B4%E7%BE%8E%E5%9B%BD%E4%BF%9D%E5%81%A5%E6%B3%95%E6%A1%88

忘了之前在那篇文章看到, Amazon很大一部份員工都是中低收入戶

作者: david31408    時間: 2018-2-2 10:31

我也是這麼想的
以退為進
老巴才說沒跟到亞馬遜
哈哈 現在自己合組聯盟
到時候亞馬遜就賣藥了
線上幫老巴賣保險
大家跟摩根借錢
只是我覺得奇怪 怎麼不是富國銀行

QUOTE:
原帖由 chousirbuy 於 2018-2-1 22:17 發表
我很直覺的就想到以後可以在亞馬遜上用很方便的方式和老巴簽保單,而且可以從JP銀行自動扣款然後保單組合自己決定,不用請人,不需要房地產
接著亞馬遜再用很利害的數學程式教人如何自己選保險組合, 順便取代經 ...


作者: baggiotsai    時間: 2018-2-2 11:31

Amazon 第四季財報 (2017) 18.56億    (2016)7.49億
作者: mikeon88    時間: 2018-2-2 11:37

都是因減稅
作者: mikeon88    時間: 2018-2-13 09:33

The distribution segment generated about $195.9 billion in revenue in the last year. We have to point out that although the distribution segment is generating almost all of McKesson’s revenue, it has an operating margin of only 1.7% while the technology solutions segment has an operating margin of 12-13%.

MCK藥品配售營利率才1.7%,亞馬遜的利基不大。
作者: Raimu    時間: 2018-2-13 11:59

低毛利是優秀的護城河
作者: Curry    時間: 2018-2-13 12:38

Raimu桑,小弟也有同感,WMT就是一個例子!
作者: mikeon88    時間: 2018-2-13 17:39


作者: mikeon88    時間: 2018-2-13 21:16

利潤率高低跟周轉率有關,
為何MCK藥品批發商營利率2%不到可以賺錢,因周轉率高,
下游ESRX藥房營利率要高到6%,因藥房的藥品需等客戶上門買,周轉率較低。

所以亞馬遜和巴菲特以為美國藥價貴是因為通路沒效率,看來並不成立,
以MCK和ESRX的營利率這麼低來看是有很好效率的,
亞馬遜想進來是討不到便宜的。
作者: mikeon88    時間: 2018-2-15 15:12

We asked Jamie Dimon why JPMorgan is forming a new healthcare company with Amazon and Berkshire Hathaway — here's what he saidGrant Eizikowitz and Lydia Ramsey


FACEBOOKLINKEDINTWITTEREMAILEMBEDAMZN  Amazon.Com
1,451.05  36.54 (+2.60 %)



DisclaimerGet real-time AMZN charts here »

JPM  JPMorgan Chase
115.03  2.60 (+2.30 %)



DisclaimerGet real-time JPM charts here »



Jamie Dimon is fed up with the way America does healthcare.
In a conversation with Business Insider's Matt Turner, the JPMorgan CEO explained why he, along with Amazon and Berkshire Hathaway, are banding together to form an independent nonprofit venture to lower healthcare costs for their employees.
When it comes to how the US spends on healthcare, it often doesn't make a lot of sense.
"Look, America has an issue, OK? We spend 17% of our GDP in healthcare. You know we have the best of all worlds, some of the best healthcare in the world. And the worst of all worlds. We don't do very good preventive medicine. It costs too much," Dimon said.
The rising spending is something Berkshire Hathaway CEO Warren Buffett has called the "hungry tapeworm on the American economy."
And getting people to be more active consumers in the healthcare system with health plans that feature deductibles—the amount of money paid out of pocket before insurance kicks in — hasn't gone over as well as expected.
"Going into deductibles was important to get you to shop a little bit but hasn't really worked really well," Dimon said.
The three companies are self-insured employers, which means that when you're an employee going to a doctor's appointment, your employer is ultimately footing the bill for the MRI you receive, rather than a health insurer. The insurance companies are there in the middle to handle the logistics of getting the claim from one place to another.
"So I tell people, JP Morgan Chase already buys a $1.5 billion of medical, and we self-insure," Dimon said. "Think of this, we're already the insurance company, we're already making these decisions, and we simply want do a better job."
JPMorgan for example has lowered deductibles for employees who make less than $60,000 a year. The deductible can also be tied to lifestyles as well, bringing that deductible even lower.
"If you do your wellness stuff now, if you take care of yourself, if you don't smoke, we give you benefits and the deductible effectively goes to zero," he said. "So we've kind of really made it easier for folks to get proper medical care."
Dimon said he started chatting with Buffett and Berkshire Hathaway investment officer Todd Combs, who also sits on the board of JPMorgan, and Amazon CEO Jeff Bezos.
"We said, we know we can do more. We know we can do more just thinking through every single part of it," Dimon said. Whether that be giving employers more information on their phones, which could in turn help with their overall wellness. Keeping employees healthier for longer in turn could cut down on healthcare spending by preventing patients from getting sicker.
"There are ways that, when you face this, maybe we can change things to make it much better for everybody," Dimon said. "We want happier employees, better medical outcomes, and I do think at the end of the day that'll actually be cheaper."
Following is a full transcript of the conversation.
Matt Turner: JP Morgan announced an initiative with Amazon and Berkshire Hathaway. How did that come about, and what are you hoping to achieve there?
Jamie Dimon: Look, America has an issue, OK? We spend 17% of our GDP in healthcare. You know we have the best of all worlds — some of the best healthcare in the world. And the worst of all worlds. We don't do very good preventive medicine. It cost too much. Warren Buffett calls it the tapeworm of corporate America.
Going into deductibles was important to get you to shop a little bit but hasn't really worked really well. So I tell people, JP Morgan Chase already buys a billion and a half dollars of medical, and we're self-insured. Think of this: We're already the insurance company, we're already making these decisions, and we simply wanna do a better job.
And in conversation with Warren, and someone who works for him called Todd Combs, who's one of my board members, who's exceptional, and Jeff Bezos, we said we know we can do more. We know we can do more just thinking through every single part of it. Both the customer-facing part so you might be able to get look at more data on your phone and stuff like that, getting you do wellness.
I mean, 20% of our medical expense is at end of life, and a lot of people don't want to go through it — they go through it in a hospital. So maybe we need a legal change of that. A lot of people over-utilize certain medicines, but they also under-utilize it. And it's also silly they have no wellness. Like, if you take care of yourself, I think smoking and obesity — I forgot the number — account for 25% of all medical expenses. Well, that's us!
So, you know, there are ways that when you face this maybe we can change things to make it much better for everybody. We want happier employees, better medical outcomes, and I do think at the end of the day that'll actually be cheaper.



作者: mikeon88    時間: 2018-2-15 15:15

Business Insider 記者訪問JPM老闆談三巨頭合組公司,
內容蠻空洞的,
希望建立員工自我健康管理,降低吸菸及肥胖率,
......
我就放心了。
作者: Curry    時間: 2018-2-15 15:33

這樣就對了...
蒸的很放心
顆顆∼
作者: Curry    時間: 2018-2-19 07:27

Charlie Munger: Rising medical costs in the US are 'evil'Berkshire Hathaway’s (BRK-A, BRK-B) vice chairman, Charlie Munger, is “all for” his company and other corporate giants figuring out how to cut costs in the U.S. healthcare system.
Back in January, Amazon (AMZN), JPMorgan Chase (JPM), and Berkshire Hathaway announced a partnership where they’re working together to address rising health care costs in the U.S. for their employees.
“The existing system runs out of control on the cost side and it causes a lot of behavior, which is not only regrettable, it’s evil,” Munger, 94, said at the Daily Journal’s (DJCO) annual meeting.
He added that there’s a lot of “totally unnecessary” costs that have crept into the medical system. His comments on Tuesday echo what he’s said for years. At Berkshire Hathaway’s annual shareholder meeting in 2017, he said there’s “too much medicine” and “too much chemotherapy” for people who are “all but dead.”
The Amazon-JPMorgan-Berkshire Hathaway partnership will look at how the incentives have gone wrong and come up with a solution.
“Of course, that’s a very difficult thing to take on,” Munger said. “I don’t know how it will work out.”
Presently, the American medical system is like vultures treating the sick like a “carcass.”
“It’s not right to bleed so much money,” he said, adding that it’s “deeply wrong” what’s happened.
作者: Curry    時間: 2018-2-19 07:33

蒙格(老巴的貴人)說:這很困難,我們甚至不知道怎麼work on...






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