Haven -- the joint health care venture by Amazon, Berkshire and JPMorgan -- is shutting down - CNN

Rich companies and investors with tremendous cash reserves often try to add health care to their book of companies.  Not many are successful.  Often their ventures last one to three years due to their unprofitability due to lack of demand for their services (often because there is much competition for others who have much more experience.   I try to be optimistic as to their intentions, thinking they are here to help, but more often than not there is a profit motive. These folks really do not have a clue about providing health care when they come at it from a consumer or business approach.  Those in health care already are more altruistic and continue to operate at a loss, until a financial backer, bank or otherwise begins to lose money on their own stake in the game.  

Haven, an ambitious health care company formed just three years ago as a partnership between Amazon, Warren Buffett's Berkshire Hathaway and JPMorgan Chase is shutting down.  The only thing the investors did correctly was to hire Atul Gwande M.D, a well-respected medical writer, researcher and surgeon. Always willing to have additional income he accepted the position as COO. However after 12 months, he recognized the perverse incentives and lack of forethought forming Haven, he bailed out.  His reputation remains only slightly blemished the brush with entrepreneurs. 

"Haven will end its operations at the end of February," said Haven spokesperson Brooke Thurston in an email to CNN Business. The news was first reported by CNBC.

Why Haven Healthcare Failed HBR

Insufficient Market Power

Perverse Incentives

Poor timing

The venture was created in 2018 with the goal of helping provide better health care services and insurance at a lower cost to workers and families at these three leading American firms -- and potentially to other US companies as well.

But Haven had struggled to make inroads beyond its three partners since its inception. Haven CEO Atul Gawande stepped down last May and chief operating officer Jack Stoddard also left the firm in 2019 after just a few months' tenure.

JPMorgan CEO Jamie Dimon wrote in an email to employees, "Haven worked best as an incubator of ideas, a place to pilot, test and learn -- and a way to share best practices across our companies. Thurston told CNN Business that "moving forward, Amazon, Berkshire Hathaway, and JPMorgan Chase & Co. will...continue to collaborate informally to design programs tailored to address the specific needs of our individual employee populations and locations." Amazon was encouraged by it's foray into buying a pharmacy, relabelling it "Pillpak" and applying some of. its experience with unique packaging and mail orders. It probably did not require much capitalization to purchase an already existing pharmacy (mail order) and adopt their rich experience in software and shipping experience.

 The original three partners did not have a focused goal for the new entity. Operationally it was established as a tool for their own enterprises, and their own employees.  The plan was to throw money at the wall, and see if stuck, and go on from there. 

The risk became apparent when their easy money becomes hard and they withdrew.  Business people are averse to any loss in the short or long term unless they see profits within a reasonable time.  Knowledgeable people know healthcare is not a profit center.  It is there to maintain people's health, for better or worse. It is a never-ending struggle. 

Berkshire Hathaway, run by billionaire Warren Buffett, has recently been looking for bargains in the health care sector.

Berkshire disclosed in November that it bought shares of Covid-19 vaccine developer and Big Pharma leader Pfizer (PFE) in the third quarter. Buffett's firm also invested in AbbVie (ABBV), Bristol-Myers Squibb (BMY) and Merck (MRK).

Haven -- the joint health care venture by Amazon, Berkshire and JPMorgan -- is shutting down - CNN

Primary Care Doctors Look at Payment Overhaul After Pandemic Disruption

Three-quarters of the more than 500 doctors contacted in an online survey by McKinsey & Co. said they expected their practices would not make a profit in 2020.
A study in the journal Health Affairs, published in June, put a hard number on that. It estimated that primary care practices would lose an average of $68,000, or 13%, in gross revenues per full-time physician in 2020. That works out to a loss of about $15 billion nationwide.

The pandemic impacted an already festering economic climate for primary care physicians as well as specialty physicians. Surgical and other specialists such as Radiologists who depend upon referrals, and the ability to perform routine procedures also saw a precipitous decrease in volume and income.

The addition of telehealth worked well for patients, however, it did not offset the decrease in-office visits.  The saving grace was emergency authorization for reimbursement of telehealth visits by CMS, Medicaid, and private payers.

Primary Care Doctors Look at Payment Overhaul After Pandemic Disruption

The Silent Pandemic--Malaria

The general public knows little about this ongoing tragedy. The  World Health Organization knows about it, and some wealthy philanthropists (Bill and Miranda Gates Foundation) fund vaccine efforts for Malaria and HIV/AIDS.  Great progress has been made against HIV/AIDS when funds become available for these efforts.

Culex Larva growing in water, developing into mosquitoes

which transmits the Plasmodium parasite,

Malaria is a life-threatening disease transmitted to humans by infected mosquitoes. In 2018 alone there were 228 million cases and 405,000 deaths worldwide, affecting mostly children under five years of age. Scientists have long been looking for an effective vaccine, but haven’t yet been able to produce one.

Culex and Plasmodia have a complex life cycle, the mosquito, and a vector and warm-blooded animals as a host.

As weird as it seems, spit actually seems to play a big role in how blood-sucking bugs transmit infections to humans (or other animals) that they feed on.

Red blood cells with an intracellular plasmodium parasite. (see life cycle video above)

Malaria vaccines have been developed in the past, with varying results. 1,2,3,4

Malaria is predominant in Africa, however certain genetic mutations that cause sickle cell anemia afford resistance to the parasite. The gene is most prevalent in people of African descent.

A new malaria vaccine made from the rodent malaria parasite is effective in humans