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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. mhh__ · · focus · HN ↗
      PE staff are more intelligent and more shrewd than the people running the businesses they buy. Being a good doctor doesn't make you a good businessman.

      I'm not a huge fan of PE but the point of economics to deliver cheap and quality goods to consumers not keep people in a job.

      In healthcare in US in particular I think the main thing that capital should be (if regulators allow) boutique / specialists that e.g. are the best in the biz at doing MRI scans, in some states my understanding is that it's literally illegal to start a business aiming to make one small part of the process better.

      1. sailfast · · focus · HN ↗
        Remove “more intelligent” here and I’ll give you some benefit.

        The problem with healthcare “economics” is that providing high quality care is likely not as profitable as middling care, or sub-standard care.

        You say that economics is meant to deliver cheap quality goods, but in reality here economics for PE is value extraction and has nothing to do with consumer good at all - unless of course there’s more profit there. Most of the time, there isn’t.

        1. mhh__ · · focus · HN ↗
          Is Apple Inc run for consumer good or value extraction?
          1. sailfast · · focus · HN ↗
            Apple is not a PE firm. They are a public consumer goods company with a ton of different business lines. Their duty is shareholder value and making good products that sell is one way to do that.

            Value extraction is a short term play. It’s usable by most companies in a pinch, but normally only happens before their death or slow decay into zombie-dom. At least, that’s what my anecdata tells me.

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