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Who employs your doctor? Increasingly, a private equity firm

nytimes.com

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Re: Who employs your doctor? Increasingly, a private equity firm

#91

Post by cardamomo »

lordnacho wrote: post #46

To me it seems like PE has simply discovered a loophole in the system. We want a system where creating value for people is rewarded, but PE has found a way to legally get the rewards without improving society. Normally this is called a scam or a fraud, and there are laws for standard stuff like taking people's money without giving them what you promised. For PE however, they've found a way around it, using the machin…

> Normally this is called a scam or a fraud

So why not call it a scam or a fraud? I know there's likely a solid legal argument for not classifying it as such, but laws can be changed.

Re: Who employs your doctor? Increasingly, a private equity firm

#92

Post by userabchn »

digdugdirk wrote: post #47
VancouverMan wrote: post #32

This is the kind of economic distortion that should be expected when onerous government-imposed regulation of practitioners, medication, and medical devices creates barriers to entry that reduce competition. While such regulation may have been imposed to try to increase safety, quality, and consistency, for example, it also ends up interfering with the incentives of the participants. The lack of real competition, com…

Patient options and choices such as "go to the doctor" vs "go into crippling debt while trying to navigate a labyrinthine billing nightmare"? Just as an alternative point of view - you describe these regulations as "government-imposed". Would it not be equally (if not more) likely that these regulations are being created and supported by the industry players themselves? This lack of real competition that you mention…

I think choices was meant to mean things like being able to choose between competing healthcare providers.

Created and supported by big industry players that get them turned into law (and thus "government-imposed" - classic regulatory capture.

On the Mexican side of the border there are clusters of doctors, dentists, etc., offering lower cost treatment. I imagine that a large part of the decreased cost is due to reduced regulations that make it easier for small, independent providers to offer their services, which in turn results in substantial competition between the many providers to offer the lowest cost for the standard of treatment that patients want.

Re: Who employs your doctor? Increasingly, a private equity firm

#93

Post by moomoo11 »

I think if we can get more health data access then we can slowly automate out general practice type doctors.

Only doctors around will be those who are highly specialized in orthopedics, neurology, etc.

For everyone else who needs a Z pack or headache pills, they can just get their care from a AI doctor in their pocket. Why do I need to wait days or weeks to see a general practice doctor? That doesn’t sound fair.

Cuts costs heavily. Most people live long with just eating healthy and moving around. I’m sure it will be fine for most people.

I personally don’t see a doctor each year. I exercise, eat whole non processed foods (cheaper than whatever packaged crap), and I get my lab work done regularly. The only times I’ve gone in are when I broke something or was heavily bleeding from an injury.

I’ll bet if most people put down the Diet Coke in favor of a water, we would save billions of dollars right off the bat.

Re: Who employs your doctor? Increasingly, a private equity firm

#94

Post by verteu »

cscurmudgeon wrote: post #85
wpietri wrote: post #81

Earlier quoted context omitted.

If your standard for "conclusive" is "study must fork the universe to compare the same business with different timeline" then you may be waiting a while. Regardless, in this case, where the ongoing harm could be very large, we have to at some point go with the best evidence available.

> If your standard for "conclusive" is "study must fork the universe to compare the same business with different timeline" then you may be waiting a while. My standard is authors (and random internet commenters) to have an inkling of the progress in causal analysis and related progress in the last two decades. Edit: Some resources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9300826/ https://journals.sagepub.com/doi…

I'm quite familiar with causal analysis [1]. What are your qualifications in the field?

The paper performs half a dozen standard robustness checks [2]. Which exactly do you believe are missing? Be specific, and include reasons why we should reasonably expect the opposite outcome.

[1] Senior ML Researcher @ Google, top 3 PhD, etc.

[2] Placebo analysis, instrumental variables, MTE analysis, breaking down the effect into plausible mechanisms such as reduction in front-line staffing, limiting results to nursing homes owned by the same chain, etc

edit: Instead of linking random surveys on causal inference, please make a specific claim, such as "the authors should have used propensity scoring", or "causal inference studies should all be ignored." Otherwise, there's no way to have a debate.

Re: Who employs your doctor? Increasingly, a private equity firm

#95

Post by balderdash »

gruez wrote: post #21
balderdash wrote: post #7

I’m the furthest thing from having any knowledge here, but it feels like it should kind of be like how law firms can only have lawyers be owners with the idea that owners need to be aligned with codes of professional conduct/ethical obligations to clients etc

That model works well for professional services (eg. lawyers, accountants, consultants) because require very little capital. Everything from the office they work in, to the computers they type on can be leased. The same can't be said for hospitals, which cost hundreds of millions to build and equip. How are you going to raise all that capital from only the doctors? They're rich, but not that rich. Moreover, the payba…

1) There is a big difference between a hospital and medical practice, 2) this is a solved problem as it relates to other professional service firm (law firms, investment banks (back in the day)).

Re: Who employs your doctor? Increasingly, a private equity firm

#97

Post by starcraft2wol »

synetic wrote: post #30
starcraft2wol wrote: post #24

Earlier quoted context omitted.

As they acknowledge, this factor is extremely difficult to isolate from demographics, geography, religion, etc.

But it is not difficult to isolate from common sense. No one should profit from denying someone healthcare. All systems have ration care but it is immoral for someone to profit by denying care. Profit motive does not make for a good healthcare system.

That's using the theme of the study to support what you already believe, without examining what the study actually shows. I don't disagree that your reasoning sounds plausible, but that's irrelevant of the study's quality.

Re: Who employs your doctor? Increasingly, a private equity firm

#99

Post by hkon »

moomoo11 wrote: post #93

I think if we can get more health data access then we can slowly automate out general practice type doctors. Only doctors around will be those who are highly specialized in orthopedics, neurology, etc. For everyone else who needs a Z pack or headache pills, they can just get their care from a AI doctor in their pocket. Why do I need to wait days or weeks to see a general practice doctor? That doesn’t sound fair. Cuts…

Great that you have good health. It does not however make you a medical expert.

Re: Who employs your doctor? Increasingly, a private equity firm

#100

Post by kjghkjghkjgh »

synetic wrote: post #88
kjghkjghkjgh wrote: post #51

Earlier quoted context omitted.

Should a Lasik surgeon provide Lasik to everyone regardless of their ability to pay?

The lasik surgeon in your example isn’t profiting by denying care. Their profit does not increase by declining service.

Is a PE hospital profiting when it denies care too? How is that different from a lasik surgeon denying care?
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