I'm an ophthalmologist. This phenomenon is endemic to all outpatient and procedure-based medical specialties. Especially eyes and teeth but also including emergency medicine, radiology, gi etc. It absolutely does lead to poorer quality patient care as practices are purchased with a second-liquidity event in mind and thus must show an increase in margins via increased "efficiency." In reality this means less technicia…
I think this cuts both ways. I have a friend who's a recently-retired partner in an ophthalmology practice, and it was very difficult for him to find someone who wanted to buy into the partnership to take his spot. He said that many docs these days just want to go to work, do their job, and go home, without dealing with all of the additional burdens that come with owning a business. He thinks that's a big contributin…
FTC acts against private equity firm’s acquisition of veterinary clinics
241–250 of 299 posts
Re: FTC acts against private equity firm’s acquisition of veterinary clinics
#242Vet clinics became very popular private equity targets recently. One of the people I know in PE described their profit margins as being surprisingly high even before PE roll-ups. They said that some PE firms were on a mission to acquire all of the vet firms in metro areas and then drive prices up even further because the demand is so inelastic. There was a secondary rush where people were trying to acquire vet clinic…
> They said that some PE firms were on a mission to acquire all of the vet firms in metro areas and then drive prices up even further because the demand is so inelastic. This is why medical care (human or pet) and capitalism don't mix well. If you are having a heart attack, you aren't comparing prices, and if your animal "child" is throwing up, you aren't calling around various vets.
Comparing human and (non-human, but I'll omit that) animal healthcare is flawed. Humans are paying for healthcare themselves and place an infinite financial value on their own lives. Animals don't pay for their own healthcare, so it doesn't matter how much they value their own lives, what matters is how much the owner values its life, which is in many cases not at all infinite.
Re: FTC acts against private equity firm’s acquisition of veterinary clinics
#243Earlier quoted context omitted.
if only there was some kind of other option used by all developed countries except the US... too bad there isn't, i guess i'll just die when i cant afford healthcare
What is the other option? Either insurance by private or government bodies or cash is all I've ever seen. Government and private insurance raises prices. Cash excludes poor people.
To be brutal about this: we in the U.S. demonstrably pay more per person that the rest of the "developed" world, and we get worse outcomes for it, and that is not even counting that we exclude a good portion of our population (which other countries do not).
The only place the U.S. excels is at the very top of healthcare, the part that 1% of our population will ever see. We pay the top doctors the top dollar, so they come here, where they charge uber-top-dollar. At one point a lot of this was going to fund new drugs and clinical methods, which quickly filtered down to help everyone. But at this point those filter-downs are few and far between, and it is simply going to those who have the most money, or are the most visible.
Re: FTC acts against private equity firm’s acquisition of veterinary clinics
#244Vet clinics became very popular private equity targets recently. One of the people I know in PE described their profit margins as being surprisingly high even before PE roll-ups. They said that some PE firms were on a mission to acquire all of the vet firms in metro areas and then drive prices up even further because the demand is so inelastic. There was a secondary rush where people were trying to acquire vet clinic…
don't ever go to any ACCESS animal hospitals then. they're prominent in southern california, and probably beyond, and sold out to PE many years ago. they take advantage of pet owners in the most acute veterinary situations to bilk them (or their insurance) out of many thousands of dollars. it's despicable. i was so furious i nearly punched a vet there who was hard-selling me on very expensive cancer treatments for my…
Rescue organizations are often the best resource for finding a reputable vet.
One of my neighbors went to a big chain vet clinic to have her cat spayed. They charged her almost $120.
Meanwhile, the city will spay any cat you bring to the pound for free.
Re: FTC acts against private equity firm’s acquisition of veterinary clinics
#245Earlier quoted context omitted.
>It is a sad and exploitative industry. What an insulting, belittling comment. I don't know why you think veterinarians are charities, and don't know why feel entitled to pay people less than they're worth. Veterinarians hold doctorates. Four years of undergrad, four years of vet school. Many emergency vets are board certified, meaning they've done an additional 3+ years in internships and residencies. In running a p…
>Don't blame the vet for charging $5000 for a surgery. Blame owners who can't afford to raise a pet but have one anyway. What an utterly callous statement. We're mostly well paid professionals here on HN, but to suggest that the average american should be able to come up with $500, much less 5k, on a moments notice is laughably out of touch with most people's financial situation.
I think people are missing that the point here is that the prices aren't being set in a competitive market, so $5000 may just be a monopoly price. Maybe pet owners should be forced to pay the cost of treatment, but whether that's $5000 or not is what the FTC is concerned with.
Re: FTC acts against private equity firm’s acquisition of veterinary clinics
#246Earlier quoted context omitted.
I'm curious why this is as it seems to have been the case in my experience as well.
My guess is that nobody becomes a dentist because they love teeth. They do it to have a stable business. Conversely, people become vets because they love animals, and people often become doctors for the prestige or the ability to help people.
Then again I’m seeing places like Aspen Dental popping up all over the place so who knows
Re: FTC acts against private equity firm’s acquisition of veterinary clinics
#247The only answer to this issue (and make no mistake, its happening in medical care for humans too) is to not restrict conpetition. With yields so low, and the stock market still above 2019 highs, PE firms are diving into the few areas of the economy where there is value due to lack of competition and it is also not completely overheated. However, take out the permit and licensing requirements and you would plummet PE…
Now, make the kind of regulatory changes that would allow small healthcare businesses to compete successfully and create a freer market and you might get traction.
Re: FTC acts against private equity firm’s acquisition of veterinary clinics
#248Earlier quoted context omitted.
"financialization" is more a boogieman than a solid concept. More competition (the best interpretation of "de-financialization" I can imagine) is not very solid solution for something like healthcare (or yes pet care) where the demand being inelastic makes "ransoming" easy.
> best interpretation of "de-financialization" I can imagine "Financialization" means the insistence on seeing "business" as a machine which is to be optimized to maximize return on money. It's in contrast to people doing good work for a fair price. Compare these two veterinary practices. One has an owner who is a vet, who got into the practice because they love animals. They hire staff who love animals. They charge…
The problem is there's no rule you can apply that distinguished between those two, in a court of law or elsewhere. Unless you just look at if a bigger firm owns the vet office. But that doesn't help with the upselling vet or the large national organization who wants to help animals.
Re: FTC acts against private equity firm’s acquisition of veterinary clinics
#249Earlier quoted context omitted.
>It is a sad and exploitative industry. What an insulting, belittling comment. I don't know why you think veterinarians are charities, and don't know why feel entitled to pay people less than they're worth. Veterinarians hold doctorates. Four years of undergrad, four years of vet school. Many emergency vets are board certified, meaning they've done an additional 3+ years in internships and residencies. In running a p…
>Don't blame the vet for charging $5000 for a surgery. Blame owners who can't afford to raise a pet but have one anyway. What an utterly callous statement. We're mostly well paid professionals here on HN, but to suggest that the average american should be able to come up with $500, much less 5k, on a moments notice is laughably out of touch with most people's financial situation.
Re: FTC acts against private equity firm’s acquisition of veterinary clinics
#250Earlier quoted context omitted.
No idea how an increased number of vets would prevent capital from consolidating this industry.
You can’t have a monopoly in an industry with no barriers to entry. Cartels aren’t stable because every newcomer has an incentive to defect.