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Some private equity firms are furious over a paper in a dermatology journal

nytimes.com

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Re: Some private equity firms are furious over a paper in a dermatology journal

#161

Post by fjuerfilis »

lordnacho wrote: post #44

It sounds to me that what is being monetized is the authority of doctors. There's a lot of medical conditions where you rely on the doctor to tell you what to do. After all, you don't have a degree in that. Now I can buy a clinic and pressure all the doctors through an incentive scheme that they are not used to, and get them all to nudge the borderline cases into must-act cases. And chances are each individual case i…

It sounds to me that what is being monetized is the authority of doctors.

I think what you've described is really the US healthcare system as a whole.

I really don't understand why this isn't more of a focus of discussion. The US healthcare system is so monopolized, and so lacking in competition and transparency, it's obvious why healthcare costs are skyrocketing.

I understand the outrage over this story, but I don't understand why it might be surprising to some. So much of the US healthcare system is driven by similar incentives, especially at private, for-profit hospitals (and even at nonprofit public hospitals).

Think about it this way. Take some fundamental human need. Now legislate and structure society so only a relatively tiny number of people with a specific certificate, based on program completion, not skills demonstration per se, can supply that need. Go even further and structure the regulation of that certification by people who already have the certificate, under the argument that they are the only ones who are in a position to judge it. Now reinforce the whole thing by FUD arguments that any other approach will lead to catastrophe, illness, and death.

What do you think is going to happen?

Almost everything about the US healthcare system is characterized by rent-seeking, monopolies, or power structures and lack of transparency. It's begging for corruption. If you wanted to design an economic sector so as to drive up costs, you'd end up with something that looks basically like US healthcare.

Re: Some private equity firms are furious over a paper in a dermatology journal

#162

Post by bmh100 »

dctoedt wrote: post #55
jedberg wrote: post #28

Earlier quoted context omitted.

There is a strange bit about being a doctor or lawyer -- you aren't allowed to for a C corp for your own practice. However, if someone else forms the corp and you work for them, then you get all the protections of a C corp, as long as you don't own the majority share. So one thing they add is legal protection.

> There is a strange bit about being a doctor or lawyer -- you aren't allowed to for a C corp for your own practice. 1. In at least some U.S. jurisdictions (and possibly all), lawyers' practices can indeed be set up as corporations; my former firm was an example. The individual lawyers in the firm are still personally liable for their own malpractice and for that of any junior attorneys and/or staff whom they supervi…

C Corp is a legal entity classification, along the lines of S Corp, LLC, partnership, and sole proprietorship. What might be confusing is that S corps can use pass-through taxation or retained earnings (C Corp) depending on what the owners choose. There are various forms of partnerships with different levels of liabilities to the partners: general partnership, limited partnership (LP), limited liability partnership (LLP), etc. Partnerships generally provide much less protection than a C Corp.

Re: Some private equity firms are furious over a paper in a dermatology journal

#163

Post by bmh100 »

lotsofpulp wrote: post #36
yborg wrote: post #25

Earlier quoted context omitted.

This summer I made the mistake of going to a large dermatology practice with several locations because a dermatologist I had seen a few times before was unavailable. I had what turned out to be essentially contact dermatitis. The large corporate practice ended up billing almost $900 for this including an unnecessary biopsy. I assumed that this was simply a rogue practice, but this news story makes me see this in a ne…

Vertical integration is happening everywhere, especially due to advances in technology allowing for much greater economies of scale. Insurers have to combine with each other to get bigger to negotiate with providers and pharmacies, providers have to combine with each other to get bigger to negotiate with insurers, pharmacies have to combine with each other to negotiate with drug manufacturers and PBMs, drug manufactu…

When the companies are the same type of business, it is called horizontal consolidation, not vertical integration. Vertical integration is a company buying its supplier or its customer.

Re: Some private equity firms are furious over a paper in a dermatology journal

#164

Post by Viliam1234 »

angrow wrote: post #134
maehwasu wrote: post #78

Earlier quoted context omitted.

I'm not sure that knee-jerkingly smearing him (by association) as a racist eugenicist quite disproves the point that tenure is not protection from misguided attacks.

No need to turn to his associations for evidence, you're free to read his work and judge for yourself.

The whole point of character assassination is to make people less likely to actually read it.

Re: Some private equity firms are furious over a paper in a dermatology journal

#165

Post by drb91 »

Viliam1234 wrote: post #164
angrow wrote: post #134

Earlier quoted context omitted.

No need to turn to his associations for evidence, you're free to read his work and judge for yourself.

The whole point of character assassination is to make people less likely to actually read it.

You can read his work and evaluate for yourself.

Re: Some private equity firms are furious over a paper in a dermatology journal

#166

Post by profalseidol »

sizzle wrote: post #135
maxxxxx wrote: post #115

Earlier quoted context omitted.

That's one thing I noticed at my dentist years ago. It used to be a family practice but then they sold to a larger company. From then on every time I was there they tried to push another expensive treatment in addition to regular teeth cleaning. I am not an expert so how could I judge this recommendation? Maybe it's in my best interest or maybe they just want to make more money. Eventually I just stopped going there…

Yup same here, they had a rotating team of dentists who swapped seats every week and often times tried to upsell me on procedures and one had the audacity to joke I was costing them money cause I had no cavities or work needed "it's good for you, not good for me" said with a chuckle, while I rolled my eyes and got the hell out of there eventually finding a family practice I could trust.

Sounds like car dealers.

Re: Some private equity firms are furious over a paper in a dermatology journal

#167

Post by [deleted] »

maxxxxx wrote: post #116
lotsofpulp wrote: post #36

Earlier quoted context omitted.

Vertical integration is happening everywhere, especially due to advances in technology allowing for much greater economies of scale. Insurers have to combine with each other to get bigger to negotiate with providers and pharmacies, providers have to combine with each other to get bigger to negotiate with insurers, pharmacies have to combine with each other to negotiate with drug manufacturers and PBMs, drug manufactu…

That's why we should discourage company growth beyond a certain size. They grow because they are better than the competition but at some point they can just overpower any competition or just buy them out.

[deleted]

Re: Some private equity firms are furious over a paper in a dermatology journal

#168

Post by lotsofpulp »

bmh100 wrote: post #163
lotsofpulp wrote: post #36

Earlier quoted context omitted.

Vertical integration is happening everywhere, especially due to advances in technology allowing for much greater economies of scale. Insurers have to combine with each other to get bigger to negotiate with providers and pharmacies, providers have to combine with each other to get bigger to negotiate with insurers, pharmacies have to combine with each other to negotiate with drug manufacturers and PBMs, drug manufactu…

When the companies are the same type of business, it is called horizontal consolidation, not vertical integration. Vertical integration is a company buying its supplier or its customer.

Yes, I started off my comment referring to Anthem purchasing Aspire Health the previous commenter referred to which is vertical, but then I abruptly transitioned to talking about horizontal integration. I was trying to convey that because of the horizontal integration, the next step is to go vertical like insurance is doing with providers and PBMs and pharmacies.

Re: Some private equity firms are furious over a paper in a dermatology journal

#169

Post by LaundroMat »

thaumasiotes wrote: post #40
LaundroMat wrote: post #38

Earlier quoted context omitted.

In ancient Rome, Crassus owned the fire department. When there was a home on fire, Crassus would negotiate the price for extinguishing the fire with the owners or tenants. Plus ça change...

I mean, this is close to being right, but it's wrong in every one of the details. Crassus didn't own the fire department. Crassus owned a bunch of slaves who he had trained to put out fires. Crassus didn't charge for extinguishing fires. If your house was on fire, Crassus took his team and negotiated to buy your house . If you sold it to him, he'd put out the fire. There was no flow of money from you to Crassus under…

Serves me right for repeating what I have read multiple times elsewhere without researching it. Thanks!

Re: Some private equity firms are furious over a paper in a dermatology journal

#170

Post by testvox »

mschuster91 wrote: post #144
testvox wrote: post #126

Earlier quoted context omitted.

Very interesting, honestly I prefer the American system where you can be fired at any time but if fired without cause you are entitled to continue receiving some portion of your paycheck from unemployment insurance.

The problem here is that you need to be able to afford the lawyer, the time for the court proceedings etc. in order to get said money. Which means: those hit the most hard by "fire at will" are the poorest.

So if I am an employer in Germany and I fire an employee for misconduct but he claims I fired him for no reason how is the dispute resolved?
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