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The profit-obsessed monster destroying American emergency rooms

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Re: The profit-obsessed monster destroying American emergency rooms

#11

Post by ryandrake »

giantg2 wrote: post #7

The thing that doesn't get mentioned much in these conversations that I've personally seen play a big role is the regulation. When you have highly complex regulations, you end up consolidating practices. As regulations increase, the number of distinct providers/owners decrease. Many individuals don't want to run their own practice due to the complexities (insurance, etc) that exist beyond the work (treating people).…

> The thing that doesn't get mentioned much

This gets mentioned every time. The regulation boogeyman always shows up. If only there were fewer rules... everyone could make more money, the little guy would be able to enter and play fast and loose, and nobody would do the wrongdoing those rules were meant to correct/prevent. Yes, there are regulations in health care. There are regulations in almost every industry, and yes, they can be a pain to deal with. Yet people still start businesses, make money, grumble endlessly about those regulations, and society marches on. As part of the general public, who are often the victims of business's negative externalities, I'm grateful that our government still manages to regulate businesses.

Re: The profit-obsessed monster destroying American emergency rooms

#12

Post by mrangle »

namdnay wrote: post #8
giantg2 wrote: post #7

The thing that doesn't get mentioned much in these conversations that I've personally seen play a big role is the regulation. When you have highly complex regulations, you end up consolidating practices. As regulations increase, the number of distinct providers/owners decrease. Many individuals don't want to run their own practice due to the complexities (insurance, etc) that exist beyond the work (treating people).…

Regulations for healthcare exist are complex in every developed country, but in most everything works fine for a fraction of the cost, so I don’t think that’s the main issue

Ironically this statement glosses over the indisputable issue of the specifics of the paperwork volume, and the change in it over time. "Regulations exist everywhere" is far to general an argument to be meaningful in my opinion. Humans are forever limited by time and their labor capacity within it.

Re: The profit-obsessed monster destroying American emergency rooms

#13

Post by Y_Y »

giantg2 wrote: post #7

The thing that doesn't get mentioned much in these conversations that I've personally seen play a big role is the regulation. When you have highly complex regulations, you end up consolidating practices. As regulations increase, the number of distinct providers/owners decrease. Many individuals don't want to run their own practice due to the complexities (insurance, etc) that exist beyond the work (treating people).…

I'd actually be in favour of deregulating a lot of healthcare, but probably not for the same reasons as you. I think a cheap but unverified device/consultation/surgery is better than none at all (where only an unaffordable regulated option exists). But that's miles away from how society, even American society, functions. Without some mechanism to manage trust you can just remove the safeguards. It's actually quite possible to keep the safeguards and run a half-decent healthcare system, and this is surely much easier than finding a way to let people take calculated risks without causing mass deaths and a collapse in social cohesion.

Re: The profit-obsessed monster destroying American emergency rooms

#15

Post by parineum »

namdnay wrote: post #8
giantg2 wrote: post #7

The thing that doesn't get mentioned much in these conversations that I've personally seen play a big role is the regulation. When you have highly complex regulations, you end up consolidating practices. As regulations increase, the number of distinct providers/owners decrease. Many individuals don't want to run their own practice due to the complexities (insurance, etc) that exist beyond the work (treating people).…

Regulations for healthcare exist are complex in every developed country, but in most everything works fine for a fraction of the cost, so I don’t think that’s the main issue

Regulation is where protectionism and corruption manifest.

Regulation is a tool that can be used for many ends. It's not very helpful to speak about them collectively.

Re: The profit-obsessed monster destroying American emergency rooms

#16

Post by robertlagrant »

api wrote: post #9
29athrowaway wrote: post #2

MBAs will turn everyone into The Joker.

MBAs and similar types are the Western capitalist equivalent of the Soviet apparatchik: https://en.wikipedia.org/wiki/Apparatchik Entities like PE or conglomerates are a lot like Soviet bureaus: giant bastions of bureaucrats appointed to run things they have no direct expertise in running. The underlying issue here is what I call the "big dumb money problem." You get entities with more resources to deploy than intell…

> Money needs to be redistributed so the ratio of dollars to brain cells is more balanced.

It will likely do that naturally unless something gets in the way in the name of progress.

Re: The profit-obsessed monster destroying American emergency rooms

#17

Post by mikem170 »

ryandrake wrote: post #11
giantg2 wrote: post #7

The thing that doesn't get mentioned much in these conversations that I've personally seen play a big role is the regulation. When you have highly complex regulations, you end up consolidating practices. As regulations increase, the number of distinct providers/owners decrease. Many individuals don't want to run their own practice due to the complexities (insurance, etc) that exist beyond the work (treating people).…

> The thing that doesn't get mentioned much This gets mentioned every time. The regulation boogeyman always shows up. If only there were fewer rules... everyone could make more money, the little guy would be able to enter and play fast and loose, and nobody would do the wrongdoing those rules were meant to correct/prevent. Yes, there are regulations in health care. There are regulations in almost every industry, and…

Then maybe the government (i.e. the public) should pay for more of these regulations, as opposed to unfunded mandates, which small operators cannot afford.

In the example of the individual doctor's office, perhaps the government should provide software and billing systems to adhere to their mandated processes, inspectors, fund regulatory agencies, legislative support, etc.

Otherwise regulatory capture can drive out much of the competition, potentially leaving us worse off than we could be otherwise.

Re: The profit-obsessed monster destroying American emergency rooms

#18

Post by 404mm »

I live in north Texas, and the situation here is pretty much on par with the article.

Urgent Care & Emergency Room combos are here on every corner. It’s a lucrative business, so it makes sense that private equity firms are gobbling it up. But I think the more interesting problem here is one level up. Why are there so many of them? I see two possible reasons:

1. Anytime one of my family members gets sick, it’s rather hard to make an appointment with the primary care provider. They are usually booked, and it takes a day or two to get in.

2. Bills from the primary care providers tend to be significantly higher than a bill from urgent care. Anytime I go to a doctor, it’s around $300 for a basic consultation visit. Any problem easily adds $50-100 to it. My typical bill from an urgent care visit for sickness is around $150.

Both places are in-network. Anyway, that’s my experience.

Re: The profit-obsessed monster destroying American emergency rooms

#20

Post by alan-hn »

nilawafer wrote: post #19

Isn’t huge profits the definition of success in capitalism? As a capitalist society shouldn’t there be cheers instead of complaining? This part I don’t understand about American culture.

This is because its the profit focus of capitalism that is exactly the problem

Its a disconnect powered by propaganda of the definition of "success"

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