Apple health team faces departures as tensions reportedly rise over differing visions for the future

Apple has seen some high-profile departures in recent months from its health team after a series of leadership changes and internal disagreements about direction.

Christina Farr for CNBC:

Tension has been increasing within the team in recent months, according to eight people familiar with the situation, although that undercurrent started several years ago. Some employees have become disillusioned with the group’s culture, where some have thrived while others feel sidelined and unable to move their ideas forward, the people said.

Four of the eight people said some employees hoped to tackle bigger challenges in the health-care system, such as medical devices, telemedicine and health payments. Instead the focus has been on features geared to a broad population of healthy users… Wellness involves helping those who are generally healthy with areas including exercise, meditation and sleep, while medical applications target patients with specific diseases. Wellness is less risky and less regulated than diagnosing and treating disease, but it’s not where most of the cost is in the health-care system. Almost 90% of U.S. health-care expenditures are for people with chronic diseases, according to the CDC.

MacDailyNews Take: Here’s what we’d like Apple to tackle when it comes to health:

Obviously the health insurance system in the United States of America is FUBAR and an unspeakably massive drag on the economy overall.

The basic problem is that the prices of healthcare are not defined. They are elastic. What else do you buy without seeing the price upfront? Without knowing the hourly rate upfront? Or the cost of typical procedures? You go to a garage and it says on a board the labor cost per hour. It shows the cost of an oil change, brake services, a tune-up, etc. You go into Target and the price is on the product. You can compare that price with Amazon’s and Walfart’s and then decide where to buy. Not so with medical services, tests, and procedures.

Ever wonder why a new doctor asks what your insurance plan is upfront? It’s not just to determine that you have insurance, it also determines how much you’ll pay. The prices change based on the insurance company/plan. Ever wonder why, when you have “good insurance,” the doctor’s office seems excited to hear it? Or how well you’re treated over others with lesser (read: less profitable) insurance companies/plans? They want to keep you happy. You’re a high-value patient. If you’ve ever gone from crappy insurance to good insurance or vice versa, you know what we mean.

Until the medical costs are displayed upfront and everybody is charged that rate, regardless of their plan, this mess will continue. You can’t have real competition that drives down costs until the actual costs are clearly known by all parties and uniform per person regardless of their insurance or even lack thereof.MacDailyNews, March 7, 2017

As they’ve done with Apple Card in terms of transparency and easy to see cost on interest, etc., Apple could do with healthcare. Again, you can’t have real competition that drives down costs until the actual costs are clearly known by all parties and uniform per person regardless of their insurance or even lack thereof.


  1. No. The real problem at Apple is the inability of so many to see the difference between FITNESS and HEALTH. Some insist they are the same thing. And this is Apples’ administrative view. But others consider FITNESS as only the desire to be more attractive — even at the expense of long-term MEDICAL HEALTH. And these folks get very little respect at Apple, so they either adapt or leave.

  2. “Cost Shifting” is the real problem with very high inflation in health care. Go to the ER Waiting Room and look around at people waiting. How many have insurance (good or bad) and how many simply cannot afford health insurance, Those without will be seen and treated. A simple case (say a sore throat) will blow out $1K without any problem. An accident victim? You’re in the 5 or 6 digit range of fees.

    Now these fees are not going to be paid by poor folks so the Hospital SHIFTS THE COSTS to those who can pay. That, right there, is going to cost the insurance companies more and, if you have health insurance from your employer, your costs go up.

    Cost Shifting basically means that everyone faces increases because not everyone is covered, privately or with public programs. And those costs will increase regardless of the price lists on the waiting room wall. If you get taken to the hospital in an ambulance because of injuries from an accident you are not going to give a damn what the price list says. You need treatment for that busted up leg or shoulder, or you need the x-rays and scans for internal trauma. And you are going to want an OR or Burns Unit – based on your needs.

    Right now we are paying around double for health care insurance and our co-pays can drive you to bankruptcy. It’s the American Way and it really sucks for those in the bottom half (or two thirds) of the population.,

    So look at a big city ER and try to guess how many have insurance and then start thinking about Cost Shifting.

    1. Perhaps because he isn’t a medical genius and wanted an opinion from a professional on what could have been a serious injury, but proved not to be. Charging people $1000+ for an emergency medical visit with the only doctor available without an appointment seems like a problem to me. As Sparkles points out elsewhere, the $1000 bill to somebody who can’t pay will eventually be shared with all the other patients.

      1. “A slight burn on three fingers”.

        Sorry to butt in, but come on. You are way too kind, TXuser.

        If someone is too dumb to whip out their Apple internet companion to reference the thousands of pages of good vetted advice for such a medical event, then they are too stupid to own a computer. Seriously. Who above the age of 10 doesn’t know how to treat minor burns?????

        “D” is a highly opinionated poster who just proved one more reason why all Americans pay insane rates for healthcare. Because healthcare companies CAN charge that much, they WILL. Every time. There is no competition in the medical market, customers don’t shop around. Most people don’t even shop for insurance, they take whatever their employer gives them or they become deadbeats without insurance soaking us all for their had personal decisions.

        What “D” didn’t tell you is that while he knew exactly what caused the burn, the doctors that treated his son cannot, for malpractice reasons, simply accept that. They have to run a battery of other tests to make sure that’s all that is going on. They would be sued if Precious Son also had an unreported twisted ankle that occurred during the burn event. Docs have to do all this in a sterile facility (as much as possible) while the emergency room manages a constant influx of deadbeats as well as critical emergencies. So the doctor on duty has been trained to deal with everything from massive trauma to internal medicine to psychological issues — extreme overkill for a light burn. Maybe they went to a facility where they carry lots of staff and were able to push this case off to the Nurse’s Assistant, which would be appropriate. Well now you have a larger staff, another layer of management, etc. Then we have to manage insurance middlemen, insane pharma prices and policy, and so forth. Did we mention that the over-the-counter creme has to be locked up in a secure room along with much stronger medications because medical theft is on the rise with opioid addicts looking fir their next fix?

        In any other “socialist” country, D would pay slightly increased taxes but would be given burn creme for pennies at his neighborhood clinic, no wait and no insurance rigamarole. But what do I know, I’m just the son of a surgeon who hears the stories every day. I’m nit making this stuff up. My fathers office building was burglarized by some dope head looking for drugs. In the end patients had to pay for the security increases.

  3. Having worked in the medical field for many years, I have never heard of a practice where the charge for a given service varied depending upon insurance, charging anyone, the patient or the insurance company, a different amounts to different payors.. Decades ago, that was something that did happen, but it has been illegal for a long time. Practices, as well as hospitals, have a charge master which establishes the charge for every procedure. However, the only people who pay the full charge are cash pay patients. Insurance companies negotiate a reduction from the charge for their members. Every insurance company sets their own approved charge. If you contract with the insurance company to see their members, you agree to accept what they tell you will be payment in full for each service. Most insurance companies “cost share” with their members, which means they have to pay a portion of the approved charge as a co-pay or by accumulating a certain balance before insurance will pay anything, i.e., a so-called deductible. If the doctor’s office appears excited by “good insurance,” it means the insurance company has a fee schedule that is better than most. But that’s set by the insurance company, not the doctor. And how much the patient pays, that’s also set by the insurance company. Whether the insurance is “good” or “bad,” after the doctor finishes the visit, the insurance company is billed for the full amount according to the practice’s fee schedule. The insurance company then returns an Explanation of Benefits which tells the practice how much they are “adjusting” their payment down to the contracted agreement. So while it is true that your your insurance determines how much you’ll pay, it has nothing to do with the doctor’s fee schedule. Say Doctor A charges $100 for a procedure and Doctor B charges $75 for the same procedure. The insurance company authorizes $70 for that procedure with a 20% co-pay. Both doctors will get $66 from the insurance company and bill the patient $14 for the co-pay.

    Hospitals, on the other hand, have huge variances in their charge masters, as well as secret agreements with insurance companies, which can vary widely from one institution to another. Transparency here could be very beneficial. It would help some, but not to the extend implied by the MDN Take that “The basic problem is that the prices of healthcare are not defined..” It’s way more complex than that. As our President said, “Nobody knew that healthcare could be so complicated”

    1. Absolutely. Except Americans should be given the choice — public minimum standard healthcare and/or private healthcare.

      If the government was truly inept, then the expensive private balkanized insurance corporations would have nothing to worry about, and Americans would happily remain restricted to their networks.

      If on the other hand Congressmen are happy with their government healthcare, then they should expand the program for all Americans.

      The only people who think America has a superior healthcare insurance system are people who don’t use healthcare, people who have Cadillac plans from their employers, or young bulletproof kids who think they will never get old or sick. Every other nation SAVES a lot of money by eliminating for-profit insurance middlemen.

      If you like your insurance salesmen, keep them. It’s long past time that BASIC and EMERGENCY health care be covered coast to coast with a low overhead single payer option. Why would anyone reject having another option for healthcare insurance????

      1. Yes, Single Payer would eliminate from 25-30% of the total cost because it eliminates profiteers and Wall St investors and other unqualified personell from supervising the doctor’s office.

        1. Careful, if you propose the addition of a government-managed choice around here, you will be labeled a socialist. Even if it would result in increased competition and lower prices, at least 1/4 of your bipolar nation will protest. Keep your hands off my Medicare! they will shout.

          There is no perfect healthcare system in the world, but it’s pure stupidity to not learn from the nations that have lower cost and better outcomes. What do those nations all offer? Universal insurance or direct coverage. Not wristbands nagging you to close your rings.

          Here’s a simple spreadsheet displaying rankings based on WHO data. Click on the spreadsheet for details.

          Ranking in value, outcomes per cost:

          San Marino
          Saudi Arabia
          United Arab Emirates
          Costa Rica
          United States of America

          Obviously these are gross statistics and the range of cost and quality in the US is wide. As in all things, the US has the best of the best and the worst of the worst. Too bad partisan politics prevents even tiny steps toward better consumer outcomes on the lower end of the curve. Some of us observe that the US of A is overdue for significant reform, but there seems to be several large profitable lobbies that own the people’s representatives. For how evil the ACA has been painted by the cheapskates, the Trumpistas, and the self-serving Grand Old Corporatist Party, it’s interesting that they haven’t proposed anything better in the last decade. Meanwhile the dumbocrats as usual offer inadequate reforms to what remains a system more than any other in the world dominated by large corporate middlemen literally profiting by healthcare mismanagement.

Reader Feedback

This site uses Akismet to reduce spam. Learn how your comment data is processed.