Issue 11: Vaping, Amazon+Warren Buffet+JP Morgan, and more

Don't VAPE Me Bro
A bro in his natural habitat vaping
Pitched as a safer alternative to smoking tobacco and super popular amongst angsty teens, e-cigs have been all the rage the past few years. Unfortunately recent studies from NYU School of Medicine reveal that e-cigs are not as healthy as annoying ads on the radio would have you believe. In fact it turns out they can potentially cause DNA damage and lead to several different types of cancers as well as heart disease. That being said more than 80% of people believe that vaping can help them stop chain smoking Marlboro Reds. The CDC agrees that vaping is less unhealthy than smoking traditional cigarettes.


Speaking of Smoking...
The director of the CDC, Dr. Brenda Fitzgerald, was recently forced to resign from her position after it was discovered she had a long term history of investing in tobacco companies. That's right folks the lady who wants us all to stop smoking had a vested financial interest in the success of 5 of the largest tobacco companies in the world.

Catching the Flu, a Heartbreaking Experience?
A study published this week asserts that getting the flu may put you at an acutely increased risk of having a heart attack. Worse, the risk was specifically elevated for the 7 days after a laboratory-confirmation of a flu diagnosis, meaning that unfortunate patients who experience this double whammy may still be experiencing flu symptoms during the heart attack. The good news is that after those seven days, the increased risk of infarction (6x the typical rate) appears to normalize. If you needed any more evidence to convince your 66yo diabetic male smoking patient with HTN and HLD that he needs his flu shot this year, this is it. (As a side note, the flu season has rivaled the swine flu epidemic, and the shot is about 30% effective this year, which is about the average, and much better than the 2014/15 vaccine.)

Amazon’s Secret Health Tech Team 1492
Yes, Amazon has virtually taken over our lives. From Alexa to Whole Foods, we are more than dependent on Amazon; we are in symbiosis. And to nobody’s surprise, the tech giant has been secretly working to take over the healthcare industry as well. Jeff Bezos funded ZocDoc and the failed primary care group Qliance. It already has a team looking at pharmaceuticals and marketing its Amazon Web Services to hospitals, but rumors of a stealth team has emerged in the past couple months. 1492 is supposedly the codename of the team that is looking into various health care IT applications and electronic health records using hyped technology such as machine learning and data analytics tools. Job postings and members involved in the project had the code ‘a1.492’ written on their LinkedIn descriptions, but have been removed subsequently. Amazon has also apparently had a secret meeting in Seattle about a year and half ago at which representatives from successful healthcare networks such as Iora and Kaiser Permanente attended. Last week, Amazon hired Mark Levine, an influential geriatrician in Seattle who ran the Iora Health clinics in Seattle as a market medical director for four years. Could it be that he will join the stealth tech team 1492 and help Bezos venture into their own version of the newfoundland? Will Alexa one day become Dr. Alexa? In any case, let’s hope that Amazon makes meaningful impact in the healthcare industry, not just take more of our money.

The age old story of employer vs medical industrial complex
There are some healthcare economists in the US who think that it is impossible to improve the quality of care, increase access to care, and lower healthcare costs all simultaneously. And that to do one better, you would inadvertently rock the boat and worsen another aspect. This may be true if the assumption is made that we operate within the constraints of the legacy ecosystem of our medical industrial complex. Inefficient, bureaucratic, bloated, and extremely expensive. Employers have been baffled in the past 20 years as healthcare costs have skyrocketed with no end in sight - the average cost for an American family more than 18,000 dollars per year for coverage. Some see escalating healthcare costs as a crucial component that will destroy the American Dream as an employee’s cost to a company is ever so more burdensome due not to increasing salaries but rather to increasing costs to provide healthcare coverage.

Amazon + Warren Buffet + JP Morgan
Then enters a trio that plans to alter the course of healthcare in America forever. Berkshire Hathaway, Amazon and JP Morgan Chase have announced a joint statement that they want to form a new healthcare company to reduce the burden of healthcare on the economy while at the same time trying to improve quality of care and outcomes. The program would initially only be for employees and their families. Amazon has over 500,000 employees, Berkshire Hathaway brings more than 350,000 employees, and JP Morgan has more than 250,000 workers. Together, this healthcare company would potentially serve more than a million individuals. Further details remain scant at this time, but we know they intend to focus on “technology solutions”.

Disrupting the Fu*k outta Health Insurance
These players are not to be underestimated – Amazon is the largest online retailer in the US, JP Morgan Chase is the largest bank in the US, and Berkshire Hathaway is owned by famous billionaire investor Warren Buffett. This is a headline that follows other large scale efforts where employers band together to tackle on the old guard of pharma and hospital groups. Early speculation from a variety of sources would have us believe that they want to create an electronic platform to make healthcare workflows fluently integrated into patient, employer, and healthcare providers. Now we simply sit back and watch as traditional health insurance companies stock prices tumble.



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