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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

#151

Post by lapcat »

brightball wrote: post #134
lapcat wrote: post #114

Earlier quoted context omitted.

> To me it seems like PE has simply discovered a loophole in the system. The fundamental loophole is that "the free market" is practically a religion in the United States (the so-called Invisible Hand taking the role of a god doling out rewards and punishments), and a significant portion of the population is vehemently opposed to any regulation of capital. You can even see this attitude in some of the comments here,…

In the US, the problem is too much regulation but that regulation comes from different levels like insurance companies, medicare, medicaid, etc. I know somebody who owns a therapy business. Medicaid rates have not increased in 15 years and increasingly make it harder and harder to do your job. The level of stress and pressure it creates is intense. What do you think is going to happen when private equity comes around…

> In the US, the problem is too much regulation but that regulation comes from different levels like insurance companies, medicare, medicaid, etc.

If only there were a single payer. ;-)

Seriously, there should be single-payer health care. Also, there's the fundamental question of whether you view health care as a political right or as a personal privilege. The free market is very good at serving the privileged, not so great at serving everyone universally, equally. If you're ok with millions of people having little or no health care, that's definitely what you'll get with a totally free market for health care.

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

#152

Post by synetic »

kjghkjghkjgh wrote: post #129
synetic wrote: post #116

Earlier quoted context omitted.

A large majority of people going into scientific research do so for a love of the subject and not to become rich. They just want to make enough money to live a decent life and pursue knowledge.

Yes and their university medical research typically requires infrastructure and funding, which are often provided by for profit pharma corporations.

The following is sarcasm. If only one could think of a mechanism by which an entity controlled by people elected by the voting public could fund such things.

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

#153

Post by jmoak3 »

PE can be replaced with "Some guys".

PE bought your hospital? More like, "some guys" bought your hospital.

Ask why "some guys" bought it instead of using their money in the market, or why your hospital sold in the first place. As anyone who's company has been purchased by private equity knows, it's probably because your hospital wasn't doing so hot to begin with and "some guys" were willing to gamble that they could turn it around and make some money before it blew up. This will mean turning the screws on the customers and employees and creating a sucky environment. But this is just accelerating what was likely already an inevitable decline.

As with any risky investment, there's a solid chance the PE firm will lose money on the gamble.

See this recent hacker news submission: https://news.ycombinator.com/item?id=36048464, 30% of rural hospitals are closing due to costs growing faster than revenues.

Hospitals, in many cases, are not good businesses. Especially in places where doctors, nurses, and other staff can demand a premium based on their local market's dearth of professionals. PE firms in my opinion are part of the slow death of these failing businesses - the last attempts of "some guys" desperate for returns trying to squeeze blood from a rock that everyone else was avoiding.

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

#154

Post by synetic »

starcraft2wol wrote: post #97
synetic wrote: post #30

Earlier quoted context omitted.

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.

We live in an imperfect information world. We do studies and try our best to determine cause/effect. Rarely can such a study be a proof. This is where common sense comes in. Sometimes it is wrong too.

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

#155

Post by shadowfox »

monero-xmr wrote: post #122
lapcat wrote: post #114

Earlier quoted context omitted.

> To me it seems like PE has simply discovered a loophole in the system. The fundamental loophole is that "the free market" is practically a religion in the United States (the so-called Invisible Hand taking the role of a god doling out rewards and punishments), and a significant portion of the population is vehemently opposed to any regulation of capital. You can even see this attitude in some of the comments here,…

Unlike in Europe and the UK, where such political influence from corporations and the wealthy never happens /s At least in the US we (try) and make donations public. The places where it’s “banned” are black holes.

> At least in the US we (try) and make donations public. The places where it’s “banned” are black holes.

That is definitely an interesting take. So, is your ideal society one where anybody is allowed to give and take bribes as long as it is public?

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

#156

Post by MattGaiser »

wpietri wrote: post #74
lr4444lr wrote: post #59

Earlier quoted context omitted.

More like running many kinds of businesses has become more hassle than its worth. Medical malpractice premiums are very high, insurance payouts are stingier, and medicine has become more capital intensive than ever as newer medicines and diagnostics increasingly dominate, along with an aging population that needs more intensive care. Doctors report being more burnt out than ever. It's an attractive proposition to out…

This would be a good argument if it were only medical practices where PE was active and having a malign effect. But that's most definitely not the case.

That just means for numerous professions, running a business is more hassle than it is worth. Accounting, dentistry, massage, etc. all come to mind. Those people want to all practice their field, not deal with licenses, paperwork, insurance, and tax. Everything from burnout to higher required investment to increased regulatory hassle applies to other fields as well.

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

#157

Post by jimnotgym »

Time to get my part subject in.

PE firms often control boardrooms without taking seats. Maybe they have the right to appoint a director but don't take it up, but come to board meetings anyway. The legal phrase for someone with control, but not registered as a director is 'shadow director'. Shadow directors are supposed to have the same responsibilities legally as real directors. In practice they get the real directors to risk sanction for insolvency and don't risk themselves. This needs tightening up massively.

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

#158

Post by moomoo11 »

hkon wrote: post #99
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.

Never said I was. Just a victim of never getting an appointment when it’s most necessary. And it’s factually true that Diet Coke isn’t necessary for the health of the body.

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

#159

Post by nirvdrum »

brightball wrote: post #134
lapcat wrote: post #114

Earlier quoted context omitted.

> To me it seems like PE has simply discovered a loophole in the system. The fundamental loophole is that "the free market" is practically a religion in the United States (the so-called Invisible Hand taking the role of a god doling out rewards and punishments), and a significant portion of the population is vehemently opposed to any regulation of capital. You can even see this attitude in some of the comments here,…

In the US, the problem is too much regulation but that regulation comes from different levels like insurance companies, medicare, medicaid, etc. I know somebody who owns a therapy business. Medicaid rates have not increased in 15 years and increasingly make it harder and harder to do your job. The level of stress and pressure it creates is intense. What do you think is going to happen when private equity comes around…

Large purchasers dictate pricing or discounts on suppliers everywhere. Walmart is famous for it. I can certainly understand the frustration, but the flipside is most people on Medicaid couldn't afford market-rate services anyway. Since we don't have a single-payer health care system in the US, unless your friend is legally required to accept Medicaid, I'm not sure this a regulation issue.

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

#160

Post by throw47474777j »

lapcat wrote: post #140
throw47474777j wrote: post #132

Earlier quoted context omitted.

> The fundamental loophole is that "the free market" is practically a religion in the United States Blaming something for being practically a religion is about as empty a piece of reasoning as it's possible to make. Why not actually suggest a solution rather than just throwing your hand up at the whole thing?

> Why not actually suggest a solution rather than just throwing your hand up at the whole thing? A solution to which problem? The solution to the problem of private equity running the medical system is government-run health care, like in most other nations, who spend less on health care per person than the US but whose populations are nonetheless healthier. Or are you talking about the problem of the severe ideologic…

> but whose populations are nonetheless healthier.

Population health is not caused by medicine.

> Or are you talking about the problem of the severe ideological divide?

Since you suggested that ideology is the “problem”, I would in fact be very interested to know if you have any ideas about how to solve it?

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