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. robmccoll · 1789957747 · focus · HN ↗

            The United States has both market forces and massive access problems. I'm not sure you can establish that causal relationship.

            1. georgemcbay · 1789959090 · focus · HN ↗

               > The United States has both market forces and massive access problems.

               It boggles my mind when I still occasionally hear people speaking out against all forms of single payer healthcare in the US saying they don't want to have to wait weeks/months to see a doctor like they do in Canada/UK/wherever.

               If I give them the benefit of the doubt of not being paid lobbyists for the medical insurance industry, I can only surmise these people haven't been to a non-emergency doctor since prior to 2020.

               Because even here in the US if you aren't fabulously wealthy with concierge medical you'll be waiting weeks/months to see a 'doctor'. And you'll almost certainly never actually see a doctor, you're going to see an overworked NP (no shade on NPs here, most of whom are great, just establishing how our medical system actually works in 2026).

               1. diamondlovesyou · 1789962040 · focus · HN ↗

                  > Because even here in the US if you aren't fabulously wealthy with concierge medical you'll be waiting weeks/months to see a 'doctor'. And you'll almost certainly never actually see a doctor, you're going to see an overworked NP (no shade on NPs here, most of whom are great, just establishing how our medical system actually works in 2026).

                  But it's simply not true. my mom broke her back last year and before we realized that her back was broken, we saw an urgent care doctor, same day, within 30mins (I don't recall the exact timescale now, but it was pretty much instant). Who promptly gave my mom an Rx and told us to go to the ER. Personally, urgent care appointments have always been available within 2hrs, and even stuff like an xray (usually in a centralized office, so some travel required) is possible same day. This isn't special treatment.

                  If someone is waiting long for care, it isn't a problem with the system - and the alternative you speak of isn't going to solve the "I'm not a medical doctor" problem either, which is the main objection to the long wait-times. Minor hypochondriac-ness notwithstanding - nothing will be able to solve that completely - money is the back-pressure mechanism to avoid waste of limited resources. Whether anybody likes it or not, doctors/xray-machines/etc are not infinite (for now heh).

                  For-profit health-care insurance companies should burn in hell, though.

                  1. lovich · 1789967915 · focus · HN ↗

                     If you break your back in a place like Canada or the UK you are also going to be seen quickly.

                     Both systems triage. The wait for non urgent needs in the US system is still weeks to months

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