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> And sterilising the room isn't even a capital expense at all, it is an operating expense. No, it’s both. Autoclave machines aren’t rented, they’re purchased.

> And sterilising the room isn't even a capital expense at all, it is an operating expense. No, it’s both. Autoclave machines aren’t rented, they’re purchased. Then ongoing usage is opex. sterilization equipment is pretty well the core of the hospital (even called the core in some) > 3) You don't even need a hospital. I've had surgery done in some dude's office. You can start with a room and build up organically if the local demand is there. That is how most other businesses expand. Walmart didn't start with a global empire. Maybe for a vasectomy it can be done in office, now tell me how a liver transplant can be done. Also if you wait for demand to fit out a hospital, that means people are dying and you’re waiting until enough of them die to decide to expand your hospital. Also a watch can be an EKG machine? If my Dr pulled out any cheap piece of equipment to use on me I’d get off the table and leave immediately.

roenxi 3y ago
1. > No, it’s both. Autoclave machines aren’t rented, they’re purchased. Eh, ok. We're talking order of magnitude single digit thousands again. I, personally and literally, can lend a friend in the medical profession that sort of money if they needed it. It isn't even close to being in the range of capital costs that would cause a monopoly to form. 2. > Livers I'm no expert here and you haven't explained why you think this is a natural monopoly. But looking at a random article [0] it is clear that no hospital is required. You need a few doctors and I'm guessing 2-4 rooms worth of equipment. There isn't much of a hospital. If you want to add in rooms for patients to stay in that would be a hospital, but the room requirements for that aren't especially demanding and can be scaled over time, reducing the up front capital cost. The equipment costs would range depending on the surgeon but even a conservative estimate of a few million dollars won't get into natural monopoly territory. 3. > Also if you wait for demand to fit out a hospital... Demand forecasting is a thing. Capitalists have solved that problem. We don't have to wait for an obvious future to materialise, people act preemptively. And it still isn't suggesting there are natural monopolies present. In fact, this "waiting until enough of them die to decide to expand your hospital" problems is one that comes with public healthcare systems, they systemically under-call demand in my view. The queue in the emergency department is typically hours long in Australia and the hospitals chronically under provide beds. We only seem to seriously expand them when people start dying and/or a major sandal occurs. One of the reasons I so like the idea of private healthcare is I'm confident that if I need care right now I will pay for it, then get it. That is not a guarantee the public system can make. Adjusting to demand is a point in favour of private healthcare; they make more money if they meet demand. 4. > Also a watch can be an EKG machine? If my Dr pulled out any cheap piece of equipment to use on me I’d get off the table and leave immediately. If you insist that your health care is expensive, that can be arranged. Good luck to you. Please also support the people who want cheap options. However it is still not evidence of a natural monopoly forming. And I'm not sure what your complaint is - an ECG machine is obviously not that difficult to organise given that it can be done for a couple of hundred dollars and also you get a watch thrown in. This is not a cost that will cripple a new doctor's clinic. If you want a fancier machine, sure. But the cost still isn't going to be that high. In industries where new business cost millions to start we still get competition entering the market, none of these borderline trivial costs like an ECG machine will stop new doctors starting practices. [0] https://my.clevelandclinic.org/health/treatments/22930-hepatectomy-liver-resection https://my.clevelandclinic.org/health/treatments/22930-hepat...

roenxi 3y ago

1. > No, it’s both. Autoclave machines aren’t rented, they’re purchased. Eh, ok. We're talking order of magnitude single digit thousands again. I, personally and literally, can lend a friend in the medical profession that sort of money if they needed it. It isn't even close to being in the range of capital costs that would cause a monopoly to form. 2. > Livers I'm no expert here and you haven't explained why you think this is a natural monopoly. But looking at a random article [0] it is clear that no hospital is required. You need a few doctors and I'm guessing 2-4 rooms worth of equipment. There isn't much of a hospital. If you want to add in rooms for patients to stay in that would be a hospital, but the room requirements for that aren't especially demanding and can be scaled over time, reducing the up front capital cost. The equipment costs would range depending on the surgeon but even a conservative estimate of a few million dollars won't get into natural monopoly territory. 3. > Also if you wait for demand to fit out a hospital... Demand forecasting is a thing. Capitalists have solved that problem. We don't have to wait for an obvious future to materialise, people act preemptively. And it still isn't suggesting there are natural monopolies present. In fact, this "waiting until enough of them die to decide to expand your hospital" problems is one that comes with public healthcare systems, they systemically under-call demand in my view. The queue in the emergency department is typically hours long in Australia and the hospitals chronically under provide beds. We only seem to seriously expand them when people start dying and/or a major sandal occurs. One of the reasons I so like the idea of private healthcare is I'm confident that if I need care right now I will pay for it, then get it. That is not a guarantee the public system can make. Adjusting to demand is a point in favour of private healthcare; they make more money if they meet demand. 4. > Also a watch can be an EKG machine? If my Dr pulled out any cheap piece of equipment to use on me I’d get off the table and leave immediately. If you insist that your health care is expensive, that can be arranged. Good luck to you. Please also support the people who want cheap options. However it is still not evidence of a natural monopoly forming. And I'm not sure what your complaint is - an ECG machine is obviously not that difficult to organise given that it can be done for a couple of hundred dollars and also you get a watch thrown in. This is not a cost that will cripple a new doctor's clinic. If you want a fancier machine, sure. But the cost still isn't going to be that high. In industries where new business cost millions to start we still get competition entering the market, none of these borderline trivial costs like an ECG machine will stop new doctors starting practices. [0] https://my.clevelandclinic.org/health/treatments/22930-hepatectomy-liver-resection https://my.clevelandclinic.org/health/treatments/22930-hepat...