Business titans face complex system in US health care push

The leaders of Amazon.com, Berkshire Hathaway and JPMorgan announced the ambitious goal of improving health care coverage all of their employees. They say they are forming a new company that will be "free from profit-making incentives and constraints" and hint its results might be applied on a broader scale. But the campaign is in its early planning stages.

Here is some of what we know, and don't know, about the plan and about the health care crisis in the United States.

WHERE TO BEGIN

When Jeff Bezos, Warren Buffett and JPMorgan's Jamie Dimon say they want to improve health care for potentially millions in the U.S., among the first questions will be: Where to start? Lower the cost of research? Increase transparency about pricing? Create a large pool of customers to increase negotiation power? Cut out middleman, such as pharmacy benefits managers, to lower costs? Lobby for new legislation to overhaul the industry? All of the above?

WHEN AND HOW FAR

All that we know is that the company is in the "early planning stages." The crisis facing Americans is here and now. In the past five years, premiums for family insurance plans arranged by employers are up 19 percent, according to a recent study by the Kaiser Family Foundation and the Health Research & Education Trust.

EMPLOYEES

The initial goal is to improve health care at Amazon.com, Berkshire Hathaway, and JPMorgan Chase & Co. The companies have an estimated 1 million workers in the U.S., combined. It is not known how many dependents rely on the companies for health care coverage. JPMorgan said previously that it spent $1.25 billion on medical benefits in 2017 for 300,000 U.S. employees and family members.

U.S. COMPANIES, LARGE AND SMALL, FACE A CRISIS IN COSTS

U.S. health care spending grew 4.3 percent in 2016, according to the Department of Health. That's $3.3 trillion, or $10,348 per person. Spending on health care accounts for a staggering 17.9 percent of the nation's gross domestic product.

Spending on health care is expected to outpace GDP growth for at least the next decade. There are no longer-range forecast that would suggest that trend will reverse itself.

AN INDUSTRY RIPE FOR DISRUPTION

The announcement by Amazon, Berkshire Hathaway and JP Morgan erased billions in stock market capitalization from companies in the health care industry in seconds, potentially a knee-jerk reaction on Wall Street to the arrival three known innovators in finance and technology: Berkshire's Buffett, Amazon co-founder Bezos, and Dimon of JPMorgan.

Shares in health insurance giant UnitedHealth Group Inc. fell more than 4 percent Tuesday. Other insurers, including MetLife Inc., Anthem Inc., Cigna Inc., and Aetna Inc. also posted declines.