Thread

1. throwaway13337 · 1789952505 · focus · HN ↗

   There's a pattern to the kinds of companies PE buys and I think it points to the real problem.

   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.

   1. Waterluvian · 1789953119 · focus · HN ↗

      The Americans simply will not reject their broken for-profit medical system wholesale. What I see is one more attempt at chipping away at it in hopes that maybe they can succeed piecemeal.

      1. claytongulick · 1789955671 · focus · HN ↗

         I'm not sure anyone has solved the problem, though.

         "For profit" isn't really the problem, fee for service is.

         Value based arrangements and capitated payment structures are real improvements.

         When you don't have any market forces constraining utilization, you get massive access problems.

         1. Wololooo · 1789965804 · focus · HN ↗

            For profit IS the problem, the fundamental issue is that there are some services that needs to be run at a loss because the profit is the service which is being provided, that is the whole point of public service and paying taxes in order to have those operated.

            Now I'm not advocating for reckless spending, you can run services with reason while staying within a spending envelope, but there is a striking difference between entities that are specifically aligned for profit and those who aren't, and this is very noticeable in the health sector, in America, were wealth directly correlates with health.

            1. bopou · 1790170940 · focus · HN ↗

               "because the profit is the service which is being provided" What does this mean? Are you saying healthcare has positive externalities and hence should be subsidised? I don't think this is true, since the positive externalities are dwarfed by the benefits the individual consumer gets.

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