5 ms·

I really don't understand how this level of consolidation has been allowed in the healthcare market. I was affected by this, couldn't get prescriptions filled f

by mlsu 2y ago

I really don't understand how this level of consolidation has been allowed in the healthcare market. I was affected by this, couldn't get prescriptions filled for 4 days. Turns out I'm not alone -- 100m people? That's 1/3rd of America's population! There is no competition in the marketplace. We need to either nationalize them or break them up. These ransomware groups are small-time compared to a nation-state adversary in wartime. At this point it's a national security issue.

kmeisthax 2y ago
Part of the neoliberal consensus that replaced progressive liberalism in the 1970s and 80s is a revisionist reframing of antitrust law in which all monopolies are judged solely by the yardstick of consumer welfare. Problem is, very few monopolies actually harm consumer welfare. Bigger businesses are able to deliver lower prices - at least initially - because they suck the redundancy out of the market. Ergo, consolidation is good actually and antitrust is self-defeating. Of course, those prices will creep up eventually, once the causal link between the consolidation and the market power has been sufficiently obscured. Look at "inflation" - every business was able to blame "supply chain issues" (that they caused by removing redundancies) during COVID to extract unthinkable price increases out of the public. Because every business has only two or three real competitors, all of whom have extreme levels of class discipline and will agree to lie their asses off to the public. This level of consolidation was allowed because your politicians stabbed you in the back in the name of the """free""" market.
- sofixa 2y ago
  > Look at "inflation" - every business was able to blame "supply chain issues" (that they caused by removing redundancies) during COVID to extract unthinkable price increases out of the public. Are you implying there were no supply chain difficulties? China wasn't under heavy lockdown for months on end? There weren't ports with months of backlog? Factories weren't closed due to lockdowns or outbreaks all around the world? That civilian aviation ground to almost a complete halt for a few months, and the cargo it used to carry now didn't need to find an alternative route? Anyone trying to pin a singular reason for the inflation spikes after Covid is at best misinformed and arguing in bad faith. Covid wrecked supply chains, Russia's invasion of Ukraine wrecked a number of important raw materials' markets (oil, gas, nickel, grain, etc), the Houthis' shenanigans impacted the Suez Canal, droughts impacted the Panama canal. Sprinkle a heavy dose corporate greed and voilà, inflation.
  - pickledoyster 2y ago
    "The biggest study of ‘greedflation’ yet looked at 1,300 corporations to find many of them were lying to you about inflation" – https://fortune.com/europe/2023/12/08/greedflation-study/ https://fortune.com/europe/2023/12/08/greedflation-study/
    - deleted 2y ago
      [deleted]
    - lotsofpulp 2y ago
      Doesn’t everyone sell at the highest price they can, without regard for their COGS? I don’t break out my household expenses when I negotiate pay at a new employer.
      - gruez 2y ago
        The meat of the article is basically "profit margins went up". The same arguably happened for software engineers. By the same logic, there should be headlines of "The biggest study of ‘greedflation’ yet looked at 1,300 software engineers to find many of them were lying to you about inflation".
      - sgarland 2y ago
        Imagine you own a grocery store in a small town. The only one, in fact, and the nearest competitor is a 30 minute drive. You, being a free market enthusiast, decide to test how much the market will bear, and raise your prices across the board. Your customers, who are also your neighbors and friends, respond by socially ostracizing you. This doesn’t exist at scale, because the people responsible for the unnecessary price hikes live far away from their customers, and do not intend to ever meet them, much less explain themselves. People should price products to make a fair profit, one where both parties are satisfied. I don’t begrudge a car salesperson for selling me a car at above their cost, but I do if it’s wildly marked up.
        lotsofpulp 2y ago
Hilift 2y ago
This is one of those companies that has middleware or back office apps that are common to many health care providers. Many different markets have their own unique apps or places where data can accumulate. I remember when paper checks were still used, a small number of companies existed to receive and catalog checks and update the accounts accordingly. I visited some, and they looked like they were spun off from bank(s) to unload the cost of what was going to be a disappearing operation. Really bare bones, disarray, and access to a lot of interesting data. Another app I found interesting was for closing mortgages. There aren't many of those, and the ones that did exist were in a lot of places and were a complete shambles, data everywhere, written in early 2000's. "Change Healthcare Inc. (known as Emdeon before rebranding in 2015, which followed its acquisition of Change Healthcare) is a provider of revenue and payment cycle management that connects payers, providers, and patients within the U.S. healthcare system. The name also refers to a company founded in 2007 which subsequently became part of the current conglomerate." https://en.wikipedia.org/wiki/Change_Healthcare https://en.wikipedia.org/wiki/Change_Healthcare
arpinum 2y ago
There is competition in the marketplace, see Waystar and Availity.
datavirtue 2y ago
They protect themselves by being publicly traded. Stop whining and start investing.

by mlsu 2y ago

kmeisthax 2y ago

Part of the neoliberal consensus that replaced progressive liberalism in the 1970s and 80s is a revisionist reframing of antitrust law in which all monopolies are judged solely by the yardstick of consumer welfare. Problem is, very few monopolies actually harm consumer welfare. Bigger businesses are able to deliver lower prices - at least initially - because they suck the redundancy out of the market. Ergo, consolidation is good actually and antitrust is self-defeating. Of course, those prices will creep up eventually, once the causal link between the consolidation and the market power has been sufficiently obscured. Look at "inflation" - every business was able to blame "supply chain issues" (that they caused by removing redundancies) during COVID to extract unthinkable price increases out of the public. Because every business has only two or three real competitors, all of whom have extreme levels of class discipline and will agree to lie their asses off to the public. This level of consolidation was allowed because your politicians stabbed you in the back in the name of the """free""" market.

sofixa 2y ago
> Look at "inflation" - every business was able to blame "supply chain issues" (that they caused by removing redundancies) during COVID to extract unthinkable price increases out of the public. Are you implying there were no supply chain difficulties? China wasn't under heavy lockdown for months on end? There weren't ports with months of backlog? Factories weren't closed due to lockdowns or outbreaks all around the world? That civilian aviation ground to almost a complete halt for a few months, and the cargo it used to carry now didn't need to find an alternative route? Anyone trying to pin a singular reason for the inflation spikes after Covid is at best misinformed and arguing in bad faith. Covid wrecked supply chains, Russia's invasion of Ukraine wrecked a number of important raw materials' markets (oil, gas, nickel, grain, etc), the Houthis' shenanigans impacted the Suez Canal, droughts impacted the Panama canal. Sprinkle a heavy dose corporate greed and voilà, inflation.
- pickledoyster 2y ago
  "The biggest study of ‘greedflation’ yet looked at 1,300 corporations to find many of them were lying to you about inflation" – https://fortune.com/europe/2023/12/08/greedflation-study/ https://fortune.com/europe/2023/12/08/greedflation-study/
  - deleted 2y ago
    [deleted]
  - lotsofpulp 2y ago
    Doesn’t everyone sell at the highest price they can, without regard for their COGS? I don’t break out my household expenses when I negotiate pay at a new employer.
    - gruez 2y ago
      The meat of the article is basically "profit margins went up". The same arguably happened for software engineers. By the same logic, there should be headlines of "The biggest study of ‘greedflation’ yet looked at 1,300 software engineers to find many of them were lying to you about inflation".
    - sgarland 2y ago
      Imagine you own a grocery store in a small town. The only one, in fact, and the nearest competitor is a 30 minute drive. You, being a free market enthusiast, decide to test how much the market will bear, and raise your prices across the board. Your customers, who are also your neighbors and friends, respond by socially ostracizing you. This doesn’t exist at scale, because the people responsible for the unnecessary price hikes live far away from their customers, and do not intend to ever meet them, much less explain themselves. People should price products to make a fair profit, one where both parties are satisfied. I don’t begrudge a car salesperson for selling me a car at above their cost, but I do if it’s wildly marked up.
      - lotsofpulp 2y ago

Hilift 2y ago

This is one of those companies that has middleware or back office apps that are common to many health care providers. Many different markets have their own unique apps or places where data can accumulate. I remember when paper checks were still used, a small number of companies existed to receive and catalog checks and update the accounts accordingly. I visited some, and they looked like they were spun off from bank(s) to unload the cost of what was going to be a disappearing operation. Really bare bones, disarray, and access to a lot of interesting data. Another app I found interesting was for closing mortgages. There aren't many of those, and the ones that did exist were in a lot of places and were a complete shambles, data everywhere, written in early 2000's. "Change Healthcare Inc. (known as Emdeon before rebranding in 2015, which followed its acquisition of Change Healthcare) is a provider of revenue and payment cycle management that connects payers, providers, and patients within the U.S. healthcare system. The name also refers to a company founded in 2007 which subsequently became part of the current conglomerate." https://en.wikipedia.org/wiki/Change_Healthcare https://en.wikipedia.org/wiki/Change_Healthcare

arpinum 2y ago

There is competition in the marketplace, see Waystar and Availity.

datavirtue 2y ago

They protect themselves by being publicly traded. Stop whining and start investing.