Linked by Thom Holwerda on Thu 1st Mar 2018 00:51 UTC
Apple

Apple is launching a group of health clinics called AC Wellness for its employees and their families this spring, according to several sources familiar with the company's plans.

The company quietly published a website, acwellness.com, with more details about its initiative and a careers page listing jobs including primary care doctor, exercise coach and care navigator, as well as a phlebotomist to administer lab tests on-site.

This new primary care group - a group of clinical staff that is run independently from Apple but is dedicated to Apple employees - will initially only serve Apple's employees in Santa Clara County, where its headquarters are located. Initially, it has two clinics in the county.

Scrip healthcare.

This is insanity.

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RE: Yeah but...
by Slll on Thu 1st Mar 2018 05:27 UTC in reply to "Yeah but..."
Slll
Member since:
2014-08-02

American healthcare is systemically less than ideal, to that much I will agree.

That said, this is BS. Apple employees are paid pretty well, Apple even offers a health plan to their employees (as most large corporations do) and all around the San Francisco Bay Area are world class hospitals and medical centers. To name just four, there's UCSF in San Francisco and Stanford Medical Center (which cooperates with Sutter Health), a network of Sutter Health/California Pacific Medical Centers, and Dignity Health.

There is a huge concentration of quality health care clinics in the area, and even the County-run hospitals like San Francisco General are pretty good, not to mention free and low-income clinics with clinics specifically for women, AIDS/HIV and mental health. Could it be better? Sure, honestly having a couple of Apple-run clinics around will probably be a boon in general for the area as having a couple of extra clinics isn't a bad thing. It just means some people that would otherwise approach a different clinic, now have the option of an employer-run clinic.

Reply Parent Score: 1

RE[2]: Yeah but...
by galvanash on Thu 1st Mar 2018 05:51 in reply to "RE: Yeah but..."
galvanash Member since:
2006-01-25

That said, this is BS. Apple employees are paid pretty well, Apple even offers a health plan to their employees (as most large corporations do) and all around the San Francisco Bay Area are world class hospitals and medical centers.


World class yes. Cheap? Not really. Sure, there are some inexpensive clinics, but they generally targeted at treating basic health issues (cold, flu, minor injuries, etc.), not preventative care - they almost all suck for that. Every time you go to one its a different doctor, there is no time to do thorough exams, you wait 2 hours for 10 minutes of time with a doctor, etc. Good preventative care is actually hard to find and is expensive when you do.

The point (and incentive) for Apple to do this kind of thing is to offer preventative care that is cheap and convenient to improve the overall health of their workers, which will lower their healthcare premiums for times when they need actual treatment at a UCSF or Stanford Medical.

There is no real incentive for conventional medical practitioners like these to do things to proactively keep people healthy - they make money by treating patients, not trying to keep them healthy. What Apple is trying to do in no way replaces the need for conventional treatments, it is simply a way to try and reduce them (and thus save money on premiums for themselves and their employees).

Also, San Francisco is like 45 minutes away from Cupertino. That isn't exactly convenient... I'm sure there are a good number of Apple employees closer to San Francisco, but most of them live south of Cupertino, not north.

Edited 2018-03-01 06:02 UTC

Reply Parent Score: 5

RE[3]: Yeah but...
by avgalen on Thu 1st Mar 2018 09:43 in reply to "RE[2]: Yeah but..."
avgalen Member since:
2010-09-23

The point (and incentive) for Apple to do this kind of thing is to offer preventative care that is cheap and convenient to improve the overall health of their workers, which will lower their healthcare premiums for times when they need actual treatment at a UCSF or Stanford Medical.

Setting up your own medical healthcare center to reduce healthcare cost? That only makes sense if outside healthcare is really expensive and you require a lot of it (having very unhealthy employees).

No, this is not for reducing cost of healthcare, it is for HR/recruitment purposes. "Here at Apple we not only pay you a good salary, we also take care of the health of you and your loved ones"

...however when my wife was being recruited by Apple and she asked them about daycare their answer was "We give you a big bag of money, you take care of daycare yourself"

Reply Parent Score: 3

RE[3]: Yeah but...
by Alfman on Thu 1st Mar 2018 15:14 in reply to "RE[2]: Yeah but..."
Alfman Member since:
2011-01-28

galvanash,

World class yes. Cheap? Not really. Sure, there are some inexpensive clinics, but they generally targeted at treating basic health issues (cold, flu, minor injuries, etc.), not preventative care - they almost all suck for that. Every time you go to one its a different doctor, there is no time to do thorough exams, you wait 2 hours for 10 minutes of time with a doctor, etc. Good preventative care is actually hard to find and is expensive when you do.


I think we have the worst of both worlds here, health care that is both extremely expensive, and crowded/impersonal/rushed.

There is no real incentive for conventional medical practitioners like these to do things to proactively keep people healthy - they make money by treating patients, not trying to keep them healthy. What Apple is trying to do in no way replaces the need for conventional treatments, it is simply a way to try and reduce them (and thus save money on premiums for themselves and their employees).


The whole thing's a mess. Between hospitals, pharmacies doctors, labs, insurance companies, the costs even for basic needs have skyrocketted. It really doesn't have to be this way, there is so much unnecessary overhead! Yet as a consumer, you can't really fight the middle men because they've made it so damn expensive to pay a provider with your own money.

https://www.npr.org/sections/health-shots/2018/02/16/585548181/an-ou...

While the $17K bill for a $100 test is ludicrous, unfortunately overcharging individuals is not all that unusual. A relative was billed $35k for giving birth at the hospital without insurance, this is not what the insurance company pays for the same service. On our bills, we see both the price that we would have had to pay in cash versus the price the insurance company itself actually paid. Low and behold, if your paying as an individual you can expect to pay 4-5 times more what the insurance company pays.

With deregulation being the norm, such price discrimination is totally legal and insurance companies are laughing all the way to the bank, they know damn well just how much it would cost consumers and employers to boycott them and instead pay bills directly.

So I am in full agreement with you that apple opening their own medical facilities may be an effective way for them to boycott this corrupt system, but it's obviously not a scalable model that most employers could follow.

Also we can't ignore Thom's point that putting even more health care into employer's hands will have negative consequences for consumer choice. I'm already annoyed that under our insurance plan today, they will no longer be covering recurring prescriptions unless we go through the pharmacies of their choosing. Obviously this was part of some backroom deal that we weren't privy to. It just sucks that employers are making health care decisions on behalf of employees and patients. I'd much prefer a system where employees got vouchers instead such that we could buy into policies of our own choosing.

Reply Parent Score: 4

RE[2]: Yeah but...
by Qetzlcoatl on Thu 1st Mar 2018 07:52 in reply to "RE: Yeah but..."
Qetzlcoatl Member since:
2005-07-06

Apple even offers a health plan to their employees (as most large corporations do)


Health plan can be very tricky thing.
For example, in Russia (and, AFAIK, a lot of CEE countries) Oracle select insurance company with cheap price but with most clinics on list below average level & only basic health issues covered. So most Oracle employees I know prefer to take money compensation instead of health plan - this way they able to pay (at least partial) for health services they really need in medical centres they trust.

Reply Parent Score: 2

RE[2]: Yeah but...
by Tony Swash on Thu 1st Mar 2018 12:34 in reply to "RE: Yeah but..."
Tony Swash Member since:
2009-08-22

I think this just part of something much bigger. I think Apple have a very long term plan to wire up health care in general and these clinics are just a proving ground for some of the technology, which also delivers a nice perk to its employees in a competitive labour market.

Note this from the 24/1/18:

https://www.apple.com/newsroom/2018/01/apple-announces-effortless-so...

For a more in depth analysis of Apple’s health strategy have a look at this from last September:

https://www.cbinsights.com/research/apple-health-care-strategy-apps-...

I wonder if this might, in part, date back to the protracted experience of Steve Jobs during his long illness, during which he was aghast at how primitive data systems were.

I love the NHS in the UK but recently having had a couple of protracted health care issue myself the thing that really struck me was just how appallingly bad and out of date the NHS information systems are. And that’s after the government has spent many billions on huge top down IT systems for the NHS all of which have essentially failed to deliver. Parts of the NHS still communicate by Fax!

There is still no way to carry a digital copy of your own health records around the various parts of the systems, so you are constantly being asked the same questions, which is then written down by hand on bits of paper, and you have to make sure at each stage of your journey through the system that each part has the essential information from the other parts. Its ridiculous that one cannot carry a secure copy of all ones health records on your devices. I think, and hope, that Apple is trying to solve this.

Reply Parent Score: 1

RE[3]: Yeah but...
by mistersoft on Sat 3rd Mar 2018 15:15 in reply to "RE[2]: Yeah but..."
mistersoft Member since:
2011-01-05

Coming from the UK and having lived my child and early adulthood in Ireland I only have personal experience of two health care models:

UK NHS - free at the point of delivery. A fully tax-funded system available to entire population "free".
or
Ireland - VHI(Voluntary Health Insurance). Partly government(Tax)funded, and partly privately/insurance funded - but the higher-earning portion of the population. This model can be looked at from both directions: Either the state is subsidising the lower than would-be insurance premiums of those paying into the VHI system. OR (or rather AND) the external revenue source from the semi-private VHI patients ends up subsidising the medical-card care of those patients from lower income situations.

And I don't think anyone with knowledge of the UK and Irish healthcare systems would seriously argue anything other that that the UK system operates at a better and more consistent level.

Having the dual funding model in Ireland allows for excuses upon excuses.

My opinion - and of course it's right - is that "free at the point of delivery model" is the only one that makes sense. When the power holders in society are beholden to the national HealthCare system-for-all for their healthcare then they have a vested interest that it works and works well.
And as long as their are systems such ss Medical Cards or Medicare/Medicaid or whatever - then those with "less" are going to have their healthcare effectively subsidised one way or the other anyway; and that is absolutely right. Anyone with money it must be remembered has (usually legally) profited/taken that value creation of others for themselves - it's how capitalism works - so the very least society can do is payback those at the worker level with 3 things: health, education and security - in equal order. All should elicit no added payment and be provided for by the state. The state is good for absolutely nothing else. (regulations come under security).

Come on U.S. brethren: Ban the guns (from the police too bar maybe 5% armed response units) and Implement a "free" taxation-paid-for National Health Service for all!! Should be simpler than putting a man on the moon, you can do it!!

:-(

Sad it probably won't be in my lifetime.

Reply Parent Score: 4

RE[2]: Yeah but...
by jburnett on Fri 2nd Mar 2018 01:07 in reply to "RE: Yeah but..."
jburnett Member since:
2012-03-29

I live here and work for an employer that has its own health clinic. Unlike Apple, only employees can use our clinic. I wish my family could use it too.

There is a huge concentration of quality health care clinics in the area


You are right, there are a lot of clinics here. For the most part they have pretty good doctors too. However, the administrators are so bad that I used to leave the state for my healthcare. For example, you mentioned Sutter/PAMF. Let me tell you about my experiences with Sutter/PAMF.

The doctors there are great. Hopefully you do not need to see them anytime soon though. My wife waited over a year for her first visit with her primary doctor. I had to wait 6 months to visit an allergist. Then, I needed to reschedule a follow-up appointment, it was going to be 3 months before they could squeeze me in again. I never made it back.

Do not even get me started on their billing. One time I received two letters on the same day. The first letter was a bill with a late charge. The other was a check for over payment, which just happened to be the exact amount needed for the bill without the late charge. I paid the fee at the office on the day of service. Nobody in their billing department could seem to fix the issue and said if I didn't pay the late charge they would put me in collections.

They also tend to keep sending bills months after seeing doctors, often with no explanation. In the end I just paid whatever they asked, sometimes for doctors I never saw. Fail to pay, you go straight to collections, effectively ending any chance of buying a ridiculously overpriced home in the next 5 years.

Dealing with the awful American medical institutions is beyond infuriating. Thankfully we have the company clinic. If we didn't, I would still be doing all my non-emergency healthcare in other countries. My wife still does most of her healthcare overseas. Let that sink in, we pay for an exceptionally expensive healthcare plan here that we avoid using because healthcare in the bay area is so bad.

Somehow we found a small, private pediatric practice for our daughter. They have only messed up one bill and are very responsive. Heck, we even have the doctors private cell phone number in case of after hour emergencies.

Bottom line, if it takes companies opening private clinics to kickstart reform on the mess we call a healthcare system, then I'm all for it.

Reply Parent Score: 3