The reason it's so bad is because dentists, doctors offices, hospitals and health insurance companies have also gone through this same massive consolidation.

CVS Health Corporation owns almost 10,000 drug stores and fills more than 20% of all US prescriptions. It also owns Aetna, the largest health insurance company in the US. It's the fourth largest US company by revenue. Another health insurance company is number five.

The largest health care operator in the US is HCA Healthcare which runs 187 hospitals, and has $60 billion in revenue.

I think it's better to look at what works well in countries other than America - A solid public health system and more regulation on private industry. The improvisation of human health has a long history of negative consequences and it's very hard to go back on.

The problem is how 'health' is defined (or lackthereof) and overprescription of drugs.

It doesn't really seem like the medical industry is going in any particular direction other than developing more subscription drugs (whos primary sure sign that theyre doing anything is the side effects) and marketing them after using regulatory capture to approve them. One time cures barely get any funding or marketing or regulatory acceleration because they're simply not as profitable.

It's a really deeply cynical industry that I don't foresee fixing itself without near-total or total collapse.

> If they can squeeze even a few percentage points of improvement out of the process it'd be a huge win in my book.

That would be s/improvement/profit though, right? I bet they absolutely can manage that squeeze, and I bet it won't register as "improvement" from your perspective.

You want Amazon to run your medical history through its recommendation and spot-pricing algorithms????

It can always get worse. :)

Lol why do you think these moves are about improvement of the process? Like its said they have a fiduciary duty to squeeze profit out of their moves. Improvement of the experience for the customer is at least orthogonal to that.

> They grow when they think they can generate economies of scale and synergies, which is good for consumers.

I've only very rarely seen these sorts of things result in anything good for the general population.

Socialism, communism, anarchism, some Democratic Socialism, and some progressivism all believe there’s moral and economic principles to not let an Amazon or CVS keep buying up companies.

There’s lots of anti-capitalist resources available online. It’s sometimes hard to find them because of the Red Scare and capitalist’s wildly violent suppression winning the Cold War. Cheers!

I don't think they should be allowed to, they're already too big, too powerful and not regulated enough.

They capture markets by loss leading, killing competition, at the same time hamstringing their suppliers/sellers with demands that are unreasonable. Only to either raise prices later or default to selling counterfeit goods, or change agreements but the market has been decimated so there is largely only a single place to source or sell goods. Then they take their war chest and do it to another industry. American medical is both extremely profitable and also extremely not profitable depending on where you sit. I do not see Amazon being a good faith participant in this field given their other business lines.

i mean i support you saying that about almost any company to promote more precise discussion but amazon literally employs like 1.5 million people and dominates both internet commerce and cloud computing, there are easier targets to argue that they aren’t “big”

This is a bit of a straw man.

Companies go out of business for a number of reasons including but not limited to -) The inability to compete with or defend against mega-corps such as Amazon, Google, Facebook etc..., -) Being poorly managed, -) Having a product that people don't want/need. It's actually quite rare that smaller companies go out of business competing with their peers.

At the end of the day - what matters more - the success and profits of private companies - or the health and happiness of humans? They're not always diametrically opposed - but they're often not conducive to one another.

That's consistent, but what it's consistent with is monopolies.

A sole proprietorship with no employees has nearly nothing in common with Amazon. Why should they have the same rules?

"We hold these truths to be self-evident, that all companies are created equal, that they are endowed by their Creator with certain unalienable Rights"

Providing equal rights to organizations with wildly different levels of power is not a path to fairness or market efficiency.

Also better keep your AWS accounts current so you can access your doctor and your pharmacy!

Also need to make sure your startup employers AWS bill is always current in case your work AWS account is linked to your personal Amazon Prime account behind the scenes somehow.

Absolutely.

Just like we need no billionaires - we need no privately owned, for-profit mega-corps.

People need to get out of this very American idea that this aggressive style of capitalistic corporate monopolisation has worked well for the world.