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The profit-obsessed monster destroying American emergency rooms

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71–80 of 163 posts

Re: The profit-obsessed monster destroying American emergency rooms

#71

Earlier quoted context omitted.

The success of capitalism is to allow basic trade in smaller communities. Once it scales to the anonymity of the large corporation and the specialist of wealth extraction, it becomes malignant.

"Our Constitution was made only for a moral and religious people. It is wholly inadequate to the government of any other" said John Adams. In other words, the government is not going to impose religion, morals, or values it expects the people to have those on their own. People who run businesses that extract wealth from the sick, the old, the dying, or people in other situations where they are not really able to make…

> In other words, the government is not going to impose religion, morals, or values it expects the people to have those on their own.

That is right. But it doesn't mean something cannot be done, such as a general uprising with organized morals against the prevailing winds of profit above all else. Slavoj Žižek said it best when he said that we are conditioned to believe that anything is possible scientifically, but we are highly doubtful of any social change. We need to reverse that: to believe that we can change the world sociall rather than technologically, or perhaps despite the technological changes.

Re: The profit-obsessed monster destroying American emergency rooms

#72

Private equity is no longer doing its job, to the extent if ever had one. If there were a poorly run company, private equity could use its own money to acquire it, restructure it to be more efficient and valuable, and capture cash flow while owning it and profit from taking it public again. They would make money, the economy would be improved, and a healthy new public company would build more public wealth. This is a…

> Private equity is no longer doing its job, to the extent if ever had one.

Private equity's job is to take a slowly failing company, extract the value, and turn it into a suddenly failed company.

See department stores in the 90s, Circuit City, ToysRUs and restaurant chains more recently.

This is a win for the former owners who get cash for their business and can blame the failure on PE, rather than admit it was on a path to fail slowly. This is a win for PE, because they can often extract enough value to make a good profit. It's a win for Spirit stores, because they get great locations like the old Circuit City that still has those maroon tiles up in 2024 and the old ToysRUs that still has the R up.

When a sector of business is being bought by PE left and right, it's a sign of unhealthy businesses and the owners want out.

Re: The profit-obsessed monster destroying American emergency rooms

#73

Earlier quoted context omitted.

The fact that healthcare is far cheaper in every European country that has universal healthcare suggests that you are wrong.

Healthcare is cheaper in every country everywhere regardless of whether they have public or private coverage. This implies that the difference isn't public vs. private, it's some other regulatory differences which are driving up costs in the US.

… it's some other regulatory differences which are driving up costs in the US.

It suggests regulatory capture and/or lack of proper governmental oversight.

Re: The profit-obsessed monster destroying American emergency rooms

#74
post #18

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…

3. Demand for immediate care is high. The next "one level up" might explore how much is because the community is quite morbid and unwell, because modern culture has displaced traditional home/self care with consumerized services, or because of other things. There are people I know who are largely healthy and who consult paid medical services many times per year for everyday disturbances, and others who take decades t…

> traditional home/self care

Not sure what you mean by this? If I have a broken bone, I'm not going to set it myself at home and take a few aspirin. Same if I'm puking my guts out.

If you just mean getting exercise and eating healthy then I fully agree with you. But, when you're actually sick, and need to see a professional, that is the right time for "consumerized services".

Re: The profit-obsessed monster destroying American emergency rooms

#75
post #52

Earlier quoted context omitted.

Many individuals don't want to run their own practice due to the complexities (insurance, etc) that exist beyond the work (treating people). It’s interesting that the one specific thing you mention is insurance. That particular complexity doesn’t come from regulation. It comes from the immoral insurance industry.

"That particular complexity doesn’t come from regulation." Considering the ACA requires insurance, it indirectly does. While there are cash-only doctors, it's very rare.

You would be onto something if the ACA was the cause. The status quo ante was an equally complex mess that covered far fewer people. The ACA more or less kept the same system in place but now covers more people.

Re: The profit-obsessed monster destroying American emergency rooms

#76

Earlier quoted context omitted.

$300 is your part of a regular doctor visit? Or the total bill? Do you have one of those high-deductible plans designed to discourage people from seeking any healthcare?

> high-deductible plans designed to discourage people from seeking any healthcare This is in fact not the purpose of those plans. They try to actually be insurance (ie, in case of unexpected high expenses) rather than a combination of insurance plus pre-payment of typical expenses.

It may not be the intent of those plans, but if it's the result, then that's what matters.

Re: The profit-obsessed monster destroying American emergency rooms

#77

Earlier quoted context omitted.

The widespread need for medical insurance only exists because regulation has introduced many artificial inefficiencies within the health care sector that in turn severely distort the pricing of medical services and medical products. We'd see far more reasonable pricing, and much less need for something like medical insurance, without the regulations that artificially limit the supply of practitioners and clinics, tha…

The fact that healthcare is far cheaper in every European country that has universal healthcare suggests that you are wrong.

But not sure americans would be okay with the limits on healthcare you got in europe. I'm from sweden and here you often have to wait several months to see a doctor if it isnt "im dying right now"-urgent. And if you got something complicated that isnt easy to diagnos but isnt killing you they will just not do anything about it.

The healthcare is good if you got something well defined and urgent like a hearth attack or cancer (but less good than cancer treatment in the US). But if you got something less urgent then you are kind of screwed.

Re: The profit-obsessed monster destroying American emergency rooms

#78
post #3

How can I avoid an ER run by private equity?

You literally cannot, or you are misusing emergency care. If you have a medical emergency you may need immediate care from EMTs in an ambulance followed by time sensitive follow up treatment. You may be trying to cope with the medical emergency of yourself or a family member in profound pain, cognitively impaired from hypoxia, drugged, or even unconscious. At best you will be unable to do anything other than dial 911 and hope or pray.

You can try to live in a state or region that where emergent care is available that isn't owned by PE, or you can live in a country other than the US. Neither of those are a guarantee that your circumstances won't change.

Re: The profit-obsessed monster destroying American emergency rooms

#79
post #35

Earlier quoted context omitted.

When I was covered by an employer plan, a lot of people seemed to gravitate towards high deductible plans because they were cheaper so long as you didn't consume a lot of healthcare. (Personally, I never did but a lot of people were adamant that you saved money that way.)

I’ve long been a proponent of high deductible plans. The part you’re missing is that you also get the opportunity to contribute pre-tax money to a Health Savings Account, which is money that you get to keep (and even invest) over the long term. You can spend that HSA money on medical expenses but if you save it, it turns into another tax-advantaged savings account like your IRA and 401(k).

It's kind of silly they tie these together. Why can't I also open an HSA if I'm on a traditional PPO plan? Or if I have no health insurance as all.

Re: The profit-obsessed monster destroying American emergency rooms

#80
post #70

I had an interesting experience in the ER lately that caused me to do some research. The average ER wait time across DC was 5 hours and 29 minutes. That's across all hospitals.

Median is better here. Average wait includes homeless people who use the waiting room for a warm nights sleep and similar outliers. They quickly get triaged and a free sandwich

Not so sure the median would be so far off here. Just earlier this week I spent about 4.5 hours in the ER in a Bay Area hospital. Not DC, but 5.5 hours doesn’t seem crazy to me.
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