Amazon is chopping jobs at its One Medical and Pharmacy units
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Without insurance or the coupon it's $1600/month. With insurance it's $650/month. With the coupon and insurance it's $0/month.
Amazon is the only pharmacy that didn't mess up the insurance. They also autoship on time every month. I'm not even joking when I say that I actually cried over how difficult it was with other pharmacies.
Clearly they were spending too much money on it. The idea is for there to be no interaction other than a payment/delivery cycle. If there are plural positive interactions the overall system was poor (needed multiple interactions) and staffing too expensive ("best" rather than mediocre).
I appreciate the incompetence by which they are doing it as it they encourages the good people to leave.
And who owns the most shares of these Companies? Organizations like BlackRock and Vanguard.
Those are just the fronts for the people who actually own the companies. Blaming them makes as much sense as blaming the local bank for wealth inequality because they hold all the money.
For those looking for chronic care and a stable doctor, I highly recommend going the route of a direct care physician. As a family of two adults and one child we pay something like $180 a month to go see a doctor anytime with no copay or visit costs. For better or worse I see this as a better outcome in the US. Pay for a DPC doctor and then a high deductible plan for emergency.
It took us 10 years to really get the hang of how to create positive operational change in big healthcare systems and it's very nuanced and slow. In a nutshell it's a lot of carrot and stick or maybe a lot of micro-carrot and micro-stick.
Amazon tried the brute force approach with Haven and it failed spectacularly. The pharmacy and one-medical plays were a dip your toes in the water approach but from what I have seen they are replaying most of the same mistakes.
I got the same type of appointment for something around $20 directly from Cigna. And that's with a high deductible account.
I doubt they're better. The Amazon of Healthcare doesn't seem like the best place for high quality doctors. but then it should be cheaper than your regular premiums and stuff.
I really don't know what they're offering.
Cigna (and any insurer) is always going to charge you way more for services that they don't provide themselves, because their direct incentive is to encourage (or force) you to use the services that they provide directly instead of using independent in-network providers. Their profit margins are way higher on those (compared to in-network providers), and furthermore they have way more control to use those as a mechanism to gatekeep further specialized care. You can sort of think of it like a loss leader, but in reverse: providing those services "at-cost"[0] allows the insurer to save way more by using that virtual visit to deny you a referral to a specialist, or denying you a particular procedure, based on some clinical guideline that the insurer has decreed, when an in-network independent provider would have come to a different judgement.
Remember that, for in-network coverage, the amount that you have to pay is a somewhat arbitrary number that is entirely decided by your insurer, and has very little (if anything) to do with how much the providers on the other end are actually making. Cigna makes you pay more for independent providers because it benefits them to charge you more for those.
I'm using Cigna here because you mentioned Cigna, but to be honest, all the insurers operate like this.
[0] "cost" is a fuzzy term here; I'm being figurative
Scheduled a quick appt for the same day, they checked up and did the first aid stuff on the knee, and then redirected me to a radiology clinic a few blocks away for an x-ray. I just checked the billing portal, and the visit to OneMedical ended up costing me $8, while the x-ray at a radiology clinic afterwards cost me $5.
So yeah, that’s just anecdotal, but your cost of $400+ for a short online appt just doesn’t feel right. Not doubting you, but I doubt that this is a typical experience.
In many (most?) states, they are actually legally required to offer services to you without a subscription, but you won't be able to use the app. In other words, you have to call them like a normal doctor's office and book an appointment, and when you do, they will have to provide you the same medical care and services that they would for any other patient.
This is not specific to One Medical; it's due to laws that prohibit additional fees for medical services. In a similar vein: in many states you can use the Costco pharmacy even without a Costco membership, although you can't buy anything else while you're there.
That said, you're not really missing out. One Medical's entire shtick is that they have a slick UX and "appointments start on time" (in theory). In practice, their medical care is... let's say variable, at best. You're paying for a slick UI and convenience slapped on top of a care delivery system that's no better than what you might get elsewhere.
For emergency services from hospitals that provide emergency services, that's true. But for virtually anything else I don't think it is.
You're thinking of a separate law, which requires emergency rooms to provide emergency medical services to all patients if they accept Medicare or are attached to a hospital which accepts Medicare. (This is one of the reasons that there's been a proliferation of standalone for-profit emergency rooms in the last several years - it's a way to bypass this requirement and serve only the most profitable patients).
That's separate from what we're talking about here.
Thanks for this connection. :)
Literally the first paragraph of the Wikipedia page about EMTALA:
> It requires hospital emergency departments that accept payments from Medicare to provide an appropriate medical screening examination (MSE) to anyone seeking treatment for a medical condition, regardless of citizenship, legal status, or ability to pay.
I don't object to people who are OK with Amazon having a hand in their health care being able to do so. I just don't want them to have anything to do with my life in general, and especially not when it comes to really sensitive things like that.
I worry that I may not end up having a choice. Or, worse, that I won't be able to tell if they're involved at all.
Others should have the ability to involve Amazon if they want, and equally I should have the ability to exclude Amazon.
Competitor services costing muliples of what OneMedical does keeps me in place for now; that, and getting an appointment and the experience of that appointment at a "normal" doctor's office is still the same as it's always been: scheduling is a massive PITA, and you're lucky if they aren't running at least 30 minutes behind by lunchtime.
The Amazon acquisition seemed like the best outcome we could hope for. Experience says it's unrealistic for OneMedical to remain independent forever, and Amazon has much better customer service than almost any other big company with a broad customer base. Insofar as the OneMedical experience was stellar mostly because it was being subsidized with ~$1B in VC/PE money (which is plausible to me), belt tightening was inevitable.
Longtime One Medical customer here, it feels the same good experience to me.
I'm at an age where if I'm going to the doctor, I want a doctor. That's harder to come by.
That's not a real option unfortunately.
"CLAIM YOUR EXCLUSIVE OFFER * Join for $99/mo (normally $149) * Ends Friday"
Sales tactics like this are literally the last thing I want from my doctor.
It is pricy, but being able to text someone at anytime and all of my basics are covered is nice. There isn't anything they can try to upsell me on since it's all included.