Bill to Ban Private Equity from Owning Medical Practices
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Bill to Ban Private Equity from Owning Medical Practices
Unofficial Hacker News client; not affiliated with Y Combinator.
throwaway13337 · · focus · HN ↗
They like companies with some kind of moat that makes it hard to unseat them. Basically, companies where there is no alternative for the consumer. That way, they can inflict abuse but know there will be nowhere to run.
There are two different ways to achieve this. Monopoly and regulation. Hospitals have both government granted locational monopoly and tons of regulations that make it impossible to compete.
Private equity is the symptom, not the disease.
Until we get at the disease, new monsters will be born with different name filling the same ecological niche. It's economic natural selection played out in the environment we created.
ip26 · · focus · HN ↗
If you want to argue from first principles, and we accept for a moment that granted monopoly is the system we are working in (whether or not you feel it's the optimal regime) then I'd argue there's a clear gap in regulation, as flagrant abuse of the consumer has not been prevented.
Nifty3929 · · focus · HN ↗
This is how industrial barons of the early-mid 20th century operated, as an example, with collusion and price fixing type things. Or hospitals and medical facilities today with certificate-of-need laws enforced by the government.
dregitsky · · focus · HN ↗
Monopolies happen due to barriers to entry, and not all barriers to entry are government-created or illegal: network effects, big upfront costs, economies of scale, control of a scarce resource, etc.
Regulation can produce a monopoly, but lots of regulations also exist to keep natural monopolies in check.
throwaway13337 · · focus · HN ↗
Maybe a term like 'natural markets' captures it better? The property being that natural markets/monopolies provide some sort of substrate on which a market can exist.
Good regulations seem to be ones that force open protocol and interoperability of these platforms that get large. This creates a new marketplace abstraction layer that enables new innovation to thrive.
I'm certainly glad that I'm not on AOL's internet. And also glad that internet exists in part due to Bell's telephone system being forced open.
Bad regulations do not seem to have that characteristic. It's too bad we do not have vocabulary to tell them apart. Public good type regulations are more muddy and can be used as a weapon more often than not.
protocolture · · focus · HN ↗
>Regulation can produce a monopoly, but lots of regulations also exist to keep natural monopolies in check.
My favourite example of this is Australias NBNCo.
Every midwit on the street capable of reading a newspaper would tell you, theres a NATURAL MONOPOLY on internet services, which is why Australia needed NBNCo.
However, the enabling legislation also made it a federal crime to overbuild the NBN, because the internet isnt a natural monopoly. We have also had calls to nationalise other fibre networks, and lots of cases of NBN overbuilding other networks.
The truth of it, is that Natural Monopoly is just a thought terminating cliche. There are barriers to entry to markets, but the only kind of monopoly is regulatory. Unless you regulate some dipshit will find a way to sneak a fibre through your power duct or something. If there was enough of an interest, we could have multiple power or water hookups too. There's no reason why we cant have competitive garbage collection, and theres probably somewhere on the planet that does. Even pit and pipe isnt a monopoly, I have seen plenty of places with multiple pit providers.