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Bill to Ban Private Equity from Owning Medical Practices

509 points · 384 comments · paimapi

  1. rrrrrrrrrrrryan · · focus · HN ↗
    It's actually worse with veterinary practices.

    Younger veterinarians are drowning in school debt and can't buy the practices from the older folks that are retiring. So, private equity is basically snatching all of them up right now, betting that childless millennials are going to pay tons of money on veterinary care when their pandemic pups begin to reach end-of-life.

    They're going to cut wages for all the staff, and hike all the prices, because unlike with human medical care, there's hardly any regulation (yet).

    1. kirubakaran · · focus · HN ↗
      My life goal that I can't work on yet is to run vet clinics as a non-profit in locations where private equity has a monopoly and are in extraction mode. With operational excellence, I think they can be out-competed by running a cost effective practice, so people don't have to decide between putting their pet down prematurely, and spending $5k per night (yes, that happened to my friend in San Francisco. $5k/night is not an exaggeration).

      The predatory businesses are able to do the extraction only because of the practical monopoly they have in a neighborhood.

      I believe the ops can be open sourced and replicated franchise style. And vets, who originally get into the career because they love animals will be drawn to it, and they have bills to pay, but that can be taken care of with a reasonable payment structure.

      I hope someone else does this so I don't have to. But I think I have to at some point. I'd also love to hear if this is a dumb idea.

      1. nradov · · focus · HN ↗
        Good luck to you and I sincerely hope that you succeed. It's not a dumb idea.

        But on the human side many health systems are non-profit, and they generally aren't any cheaper or better quality than their for-profit competition. The real problem is local market power and lack of anti-trust enforcement.

      2. duncangh · · focus · HN ↗
        I’be been similarly interested and long ruminating about whether it would be possible to achieve something similar to this in the restaurant industry. For example to have a non profit operating a franchise of a fast food location and instead of having thw 20% corporate tax rate and profit going towards retained earnings and dividends to instead be reinvested in the mission which would be better, more nutritious ingredients to better healthily feed your local customers and two to provide the staff a livable wage. Like you, I keep turning it over in my head and contemplating it rather passively as it’s way outside of my lane of Data Engineering, but I’d like to think that the market would eventually identify this as viable if it at all would be. With the ever looming fear of layoffs and future of future employment in writing software I keep thinking about that scene of the firing in “Up In The Air” where the guy they let go had always dreamt of being a chef and was finally able to pursue it after getting laid off from his high paying job that he had come to hate. Typed on my phone with my cat on my lap ; so plz excuse any run on sentences or imperfections.
      3. paimapi · · focus · HN ↗
        I love this idea but I think the PE angle also means suppliers and vendors will charge them far less for bulk order and those suppliers/vendors themselves may be a horrible little mix of MBA-brained owner practices that actively upcharges small businesses who have far less negotiating leverage

        I think the only way to do it is to have your neighborhood actively being okay with seeking local services something that a lot of neighborhood groups I frequent seem to be a big fan of (farmer's markets are an indication of this - if there's strong and regular FMs being hosted, there's people willing to burn a little extra disposable income for better, more reliable products)

      4. jfil · · focus · HN ↗
        I'd be curious to hear of your progress on this idea. Its not dumb, and it sounds similar to what co-ops do.

        >I hope someone else does this so I don't have to.

        This is a type of challenge I've been thinking of a lot. A "you have to dedicate your whole life to becoming X" challenge - I had the thought of doing something similar here in Canada with groceries. An obviously profitable business where the challenge is "how do you resist a sweetheart buyout" when the cartel comes knocking with cash...

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