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Bill to Ban Private Equity from Owning Medical Practices

509 points · 384 comments · paimapi

  1. NegativeK · · focus · HN ↗
    Can someone steelman private equity, please? I'm honestly looking for the upsides (for non-investors) of when PE moves into an industry like medicine and begins buying up businesses that traditionally aren't already large chains.

    I already hear the downsides frequently from someone whose work is directly affected.

    1. andsoitis · · focus · HN ↗
      > Can someone steelman private equity

      PE attacks organizational sclerosis, can save companies that otherwise slowly deteriorate, reallocates resources faster, creates an unusually powerful form of corporate governance, Debt can impose useful discipline, can provide capabilities that smaller companies couldn't build themselves.

      A society doesn't necessarily benefit from preserving every existing job. It benefits from creating increasingly productive jobs.

      1. pixl97 · · focus · HN ↗
        > increasingly productive jobs.

        This needs to be defined a little bit better.

        If I own a hospital that makes infinite money and every patient that comes to it dies the economy measures this is infinite productivity. This is contrived, but really matches some of what we see in real life.

        This is why making a measurement a target can be horrifically destructive and contrary to the actual goal society wants.

        The west doesn't seem to believe in the idea of social stability over increased profits which can lead to things like corporations being the social structure that is optimized for rather than the wellbeing of the individuals it contains. Left to run out of control the society can collapse.

        1. andsoitis · · focus · HN ↗
          > If I own a hospital that makes infinite money and every patient that comes to it dies the economy measures this is infinite productivity. This is contrived, but really matches some of what we see in real life.

          You wouldn't have any business if all, or many, of your patients die.

          1. AngryData · · focus · HN ↗
            The history of government regulations mostly only being made in response to people dieing seems to refute that. If what you claimed is true, those businesses killing people would have gone under, rather than continuing until there is enough public outcry to regulate it.
          2. metiscus · · focus · HN ↗
            To be fair, in an emergency one does not usually get to choose the hospital they are taken to by the ambulance company.
        2. Avicebron · · focus · HN ↗
          It seems to me that oligarchies as a whole function a lot like PE's taking over a socially unstable polity.

          The west has been an oligarchy for several decades at least, so it's not that people in the west don't believe in social stability, it's that they are living in the hollowed out shell of the former "company" where that doesn't exist. We need to optimize for the people's prosperity and well being.

          1. andsoitis · · focus · HN ↗
            > ... several decades at least .... We need to optimize for the people's prosperity and well being.

            What statistics are you looking at that makes you draw the conclusion that people are WORSE off today than, say, 20, 30, 40, years ago?

            1. pixl97 · · focus · HN ↗
              Longevity decreases, cost of living increases on every metric, rampant inflation, ever increasing economic uncertainty, increases in mental health issues, increasingly unstable populism overturning long standing institutions.

              There is also the effect where it doesn't matter if are or are not doing better by the numbers, it question is do they feel they are doing better. People act on how they feel, not on how they are.

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