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> the valorization of profit has blinded them to seeing the advantages of the public good as a worthy bottom line This is, IMO, the critical line, and also one

> the valorization of profit has blinded them to seeing the advantages of the public good as a worthy bottom line This is, IMO, the critical line, and also one of the deepest problems in the world (and especially America). A focus on profit is so frequently completely opposed to human wellbeing and a flourishing society. Just look at health insurance companies for a prime example: they make profit by denying claims. The result is a catastrophically expensive insurance bureaucracy and worse health outcomes. Not to mention the extreme stress any American feels when interacting with an insurance company over any meaningful amount of money. (Which I’ve experienced, and I have far better coverage than the average American.) These companies are so clearly, obviously bad for human flourishing. But profit is great! The incentives are so deeply messed up. Our economy only allows profit as an incentive, which works well when aligned with human wellbeing-being. But as the economy grows, companies consolidate, and profit growth is still expected, nearly every single sector looks for ways to cut costs. And with fewer competitors, it’s easier and easier for entrenched, powerful companies to raise prices and reduce quality with little consequence. This is clearly bad for human flourishing. But profits are fantastic! Just because profit is actually aligned with human flourishing in a couple sectors doesn’t mean the system as a whole will continue scaling effectively. It’s clearly not, and it must change to avoid completely suffocating us.

sschueller 1y ago
There is even worse, genocide profiteers. [1] [1] https://www.un.org/unispal/document/a-hrc-59-23-from-economy-of-occupation-to-economy-of-genocide-report-special-rapporteur-francesca-albanese-palestine-2025/ https://www.un.org/unispal/document/a-hrc-59-23-from-economy...
kovezd 1y ago
While the critique is valid, that does not offer a path to the solution. Utilitarism is the ruling moral philosophy, and the only possible countermeasure is externalities but that depends on an effective government which is even more unlikely that asking for ethical behavior to corporations.
- alpinisme 1y ago
  That may be widely believed but there are plenty of government institutions that actually function well. Libraries are a good example. What’s more: the belief in govt “inefficiency” is one of the hardest to overcome factors that makes it hard to build good institutions, leading to a vicious cycle.
  - conception 1y ago
    Exactly, people who think the government is inefficient has never worked at any company of scale ever. All large organizations are inefficient. A major problem of the US is just corruption. If people went to jail for things like congressional insider trading, we’d solve a lot of these issues.
    - jibe 1y ago
      All large organizations are inefficient. I agree, and that’s the case for dismantling as much of the federal government as possible - it is too big to work. Break up Apple, Google, Amazon, Washington DC.
      - conception 1y ago
        You’re forgetting the corollary - all small organizations are also inefficient, just at different things. It’s all trade offs - do you want everyone in your country to have a baseline education that can be relied on as a given but perhaps it suffers in its administration and effectiveness? Or are you OK with pockets of your country having tremendous quality of education and others having very poor quality, as an example.
- pergadad 1y ago
  Public utilities and services are the default and work well in the majority of developed countries. This is true for everything from local transport to water distribution. As the joke says "universal healthcare is so difficult to get right that only all developed countries except the US have managed to put it in place".
ninja3925 1y ago
> Just look at health insurance companies for a prime example: they make profit by denying claims Despite being from Europe, I find this to be a shocking and erroneous interpretation. Clearly, health insurances have the duty to allocate limited resources (“premiums”) across members. Denying and accepting claims is the mechanism to that end. Accepting all claims would increase premiums and reduce membership (by pricing people out). Would that an ideal state? Clearly not.
- n4r9 1y ago
  The point was not that all claims should be accepted. It's that adding a profit incentive to denials leads to worse outcomes.
- Aurornis 1y ago
  Healthcare debates in the United States are difficult because so many assume that insurers have very high profit margins and that arbitrarily denying claims is the reason they have high profit margins. If you look at the actual profit margins it’s low single digit percentages. You could eliminate profits altogether and virtually nothing would change. We even have non-profit insurers to look at It’s strange how the high prices of drugs and services aren’t drawing the ire of people who complain about costs. Drug prices are nearly 3X higher here than international averages and doctors here also earn a lot more with in many cases fewer restrictions on prescribing or offering services than in most EU countries. The meme that insurance company denials are generating huge profits comes mostly from the public murder of a health insurance CEO last year. For some reason people assumed that insurance companies and their profits must therefore be the core problem with high costs, without making the effort to see where the money actually goes in our health care system. As you said, there is no health care system which does not have approval processes, deny requests deemed unnecessary, require step therapy, and establish standards of care.
  - klodolph 1y ago
    > If you look at the actual profit margins it’s low single digit percentages. You could eliminate profits altogether and virtually nothing would change. We even have non-profit insurers to look at Look at administrative overhead instead of profit. People understand that there are problems with the system, and maybe they’re misattributing the problems, sure.
Aurornis 1y ago
> Just look at health insurance companies for a prime example: they make profit by denying claims. This has been repeated so many times that I think people don’t understand just how small the profit margins are for health insurers. Low to middle single digit percentages. As low as 2-3% in recent years, and much lower than the average S&P 500 corporation. There are also non-profit insurance companies out there. Their rates are not appreciably different, as you’d expect after seeing how low the profit margins are in for-profit insurers. I also think people don’t realize that countries with nationalized health care also deny procedures, have pre-approval processes, require step therapy, and will not authorize procedures they don’t believe to be medically necessary or to have enough evidence. There is no health care system in the world which will simply approve and pay for every request. So while health insurer profit margins are convenient bogeyman, if you deleted their profits entirely from the system it wouldn’t move the needle on costs. It also wouldn’t open the floodgates for approving everything, because no health care system will allow unlimited services. The amount of excess and unnecessary care would be astronomically expensive. I do agree that we need a more robust system in place for ensuring that incorrect denials don’t happen, but health insurance profit margins are barely a blip on the overall cost of health care in the United States. It’s a combination of high prices for services, American’s unusually high utilization of health care services, and very high rates of drug prescribing that mostly contribute to the cost. I think most Americans would be surprised to discover that a lot of nations with nationalized health care would also be restrictive in their access to many services and prescription drugs. For as much as we talk about insurance companies denying claims, Americans still get far more services and prescriptions than most of their counterparts in other countries.
- bestouff 1y ago
  Whatever. Simply come to a decent EU country and see how much it costs you for a bad cold or a cancer. Then compare that to the same event in the US.
  - itake 1y ago
    I've heard a horror stories about NHS and Canada's Medicare. Their systems are backed up, so treatment goes untreated for long periods of time. Presumably healthcare professionals are performing as many surgeries as they can per day. Just because one person was denied, doesn't mean another person isn't approved. For example, I'd rather get cancer in the USA than UK: https://www.politico.eu/article/cancer-europe-america-comparison/ https://www.politico.eu/article/cancer-europe-america-compar...
II2II 1y ago
I would argue that greed is the problem, not profit. One could argue that government policies are anything but altruistic. They fund public education because you need an educated workforce. They fund public health insurance because a healthy workforce is a productive workforce. You distribute the cost over the entire population. Both remove direct costs from employers (e.g. training and providing private health insurance). Both have a tendancy to reduce costs and improve consistency because you are working at a larger scale. It also creates order in society since people generally feel as though more of their needs are being met, and they feel less exploited. All of this contributes to profit both on a social scale and for individual businesses. Somewhere along the line people forgot the lessons of the 20th century. They forgot that profit goes beyond a line on the current financial statement. It also reflects long term interests.
- fsckboy 1y ago
  >I would argue that greed is the problem, not profit. I would point out that's precisely what the "private equity firm"--is that true or just a buzzword? no private equity group is taking this library private--is saying about the current library, that the greed of the unionized employees is running the library for their own benefit and at great cost to library and at the expense of the public, and it could be run more efficiently. So, you agree with them at least that much. >Somewhere along the line people forgot the lessons of the 20th century. They forgot that profit goes beyond a line on the current financial statement. huh? that wasn't "the lesson of the 20th century". if anything, the 20th century represents democracy and market capitalism's greatest joint achievement, with much less disease and starvation and much more freedom at the end vs the beginning. you live in one of the greatest times to be alive, and all you can do is complain. when and where from the past would you rather live out your life expectancy of half what it is now, coupled with no HN to bitch on?
- energy123 1y ago
  Human nature (greed) is never the problem, because it cannot be changed. Focus only on what can be changed. Design a system that manages human nature, pointing it in a direction that is beneficial, while taming its side effects. A denial of human nature is how you get authoritarian socialism with centralized planning, which leads to catastrophe because of the local knowledge problem, and because people have no private incentive to do anything. "Capitalism" is an incomplete first step towards a system which channels greed into something that's beneficial for all stakeholders. A profit-driven actor making their production more efficient to increase profits is a good thing for everyone. But capitalism is incomplete because the profit-motive can become pathological. Market failures are commonplace. The only solution that is proven to work is a mixed economy done right, with clever and lean regulations, and a government not influenced by money, and with the government stepping in occasionally to provide public goods that the market cannot, and with private actors otherwise free to make profits as long as they are not harming any third parties.
zx8080 1y ago
> A focus on profit is so frequently completely opposed to human wellbeing and a flourishing society. Not surprising considering the profit is taken from people in the society.
arjvik 1y ago
Is there a way to reward and incentivize improving human well being? Perhaps a society where all income comes from the government in proportion to how much one improves the overall well being of society? (Yes, it's difficult to measure this objectively, and even harder to agree on what the priorities for societal well being are)
- 01HNNWZ0MV43FF 1y ago
  UBI would go a long ways to enforcing democracy. Money talks, so just give people money. Everything else is too abstract. We can't seem to encode justice into law but at least if everyone got UBI it would be harder to oppress poor people (half serious)
- kortilla 1y ago
  It’s not difficult, it’s impossible under freedom of religion and just independent thought generally. One person’s “well being” might be measured by how many wives and children you have. Another’s might be education level and physical fitness. Another’s could be financial independence. These all clash with each other in fundamentally incompatible ways.
- PleasureBot 1y ago
  Germany has a different structure for company ownership than the USA. Members representing relevant stakeholders (employees, the community, environment, etc.) must be present on the board and advocate for their interests.
deleted 1y ago
[deleted]
typewithrhythm 1y ago
Conceptually neoliberal societys do not have a strong way to seperate community and social goals from economic ones, because their very philosophy is that prosperity creates social improvement. Meanwhile everyone is living in low trust economic zones with no community observable, other than anonymous services.
BrenBarn 1y ago
Totally agree. I think another angle to look at it is not "a couple sectors" but "a certain scale", as suggested by your remark about how companies consolidate. When businesses are small and need every customer, they are motivated to do a good job at what they do, build goodwill, protect their reputation. The larger they become, the more they tend to work against their customers rather than for them. They cross multiple markets, making them less responsive to the demands of any one. They become "too big to fail". And so on. What we see in the modern era is a system in which success is defined as becoming large enough that your customers have no other option but to deal with you. That's not a healthy system.
- leoedin 1y ago
  You see that scale problem everywhere. Once a business has become large, it no longer cares about “small” costs like unused buildings. That’s basically the reason so many buildings in towns and cities can be left unused for decades. The impact it has on that town is often huge. But for the business, it’s just a small overhead. A small landlord couldn’t afford to leave their asset unproductive. A multinational conglomerate can. The death of local high streets is in part due to the unwillingness of landlords to actually rent their properties out for market rate.
  - dmurray 1y ago
    I don't understand how massive corporations are both ruthless slash and burn cost-cutting profit optimizers and sloppy businessmen who don't care about the small things, even in aggregate. What's the economics of not renting out high street retail properties? There must be millions of them across the first world, with a theoretical annual rent roll in the 11 or 12 figures. Are they owned by a million multinational conglomerates foregoing a hundred grand each? In that case we are stretching the definition of "multinational conglomerate". Or are they concentrated in the hands of the same hundred companies? In that case they are each missing out on ten billion a year in opportunity. There isn't a company in the world where you couldn't make your name as Head of Global Unused Property managing ten billion a year of revenue. I don't have an answer for this either, but it must be more complicated than "they're all owned by multinationals who don't care about such small numbers" - the point of multinational companies is that those numbers are no longer small at scale.
burnt-resistor 1y ago
Public-private "partnerships" backed by private equity will always raise prices, cut costs arbitrarily, reduce service, take out loans, and saddle the organization with debt to pay themselves huge dividends before driving it into bankruptcy. This is what happens when corrupt, unregulated capitalism is allowed to run amok and have zero skin in the game except to extract maximum profit like vampires.
kortilla 1y ago
Health insurance isn’t a great example. Profits are capped relative to premium costs so denying claims isnt a good strategy. The only way denying claims can become a profit booster is to deny enough that premiums can be lowered enough to bring over more new members than was lost in revenue through the premium discount. So denied claims come from people shopping for the cheapest insurance coverage possible.
xucian 1y ago
how do we fight this?
chii 1y ago
> And with fewer competitors, it’s easier and easier for entrenched so the problem isn't with profit after all, it's with low competition? So what is causing the lack of competition in the sector? Why can't that problem be fixed?
sershe 1y ago
this narrative is basically a lie 1) Americans spend less than OECD average out of pocket as a percentage of healthcare costs. This is much larger in absolute terms but the multiplier - cost of healthcare is nearly entirely due to provider costs. 2) Health outcomes are really different between states despite having basically the same system. demographically controlled iirc outcomes are not different and sometimes better (e.g. japanese americans). 3) Insurance company profits are pretty low relative to cost of healthcare. while the bureaucracy is more expensive its not "catastrophically" by any means and iirc there are oecd countries with similar overhead although im too lazy to search on myvphone. 4) Rationing healthcare has to and does happen in all advanced economies. again modulo cost in the us, id rather it happen via money than government or inforrmal scarcity (like in Canada). 4a) Frankly while i dont have evidence for this 4a, lookinng at us spending by age (and eg the enormous money usg spends on kidney dialysis for people thay mostly just die in a few years anyway), I wonder if an important reason US providers are so expensive is, we ration limited supply properly for most people but then don't ration keeping a bedridden grandma alive for 6 more months at extreme cost, cause hey, the govt pays.
lesuorac 1y ago
> Just look at health insurance companies for a prime example: they make profit by denying claims. Ok but why do people pick those insurance companies? We see this across the board too and not just insurance companies. Governments low to pick the lowest bidder who then has massive cost overruns which has to put them above the second lowest bid in the end. Why is counter party risk never accounted for?
- antisthenes 1y ago
  > Ok but why do people pick those insurance companies? Because they are bundled with their job and most people don't have a choice?
  - lesuorac 1y ago
    Does HR get their own health insurance?
    - pseudalopex 1y ago
      Do CEOs and CFOs report to HR? Are HR heads not rewarded for cutting costs? How would people in other departments react if HR alone got better health insurance?
      - lesuorac 1y ago
        My point is that if HR picks a company that'll deny their coverage then they also have to live with their decision as well as the rest of the employees who had no choice.
        pseudalopex 1y ago
        My point was HR don't pick a company or don't pick them isolated from all other concerns.

sschueller 1y ago

There is even worse, genocide profiteers. [1] [1] https://www.un.org/unispal/document/a-hrc-59-23-from-economy-of-occupation-to-economy-of-genocide-report-special-rapporteur-francesca-albanese-palestine-2025/ https://www.un.org/unispal/document/a-hrc-59-23-from-economy...

kovezd 1y ago

While the critique is valid, that does not offer a path to the solution. Utilitarism is the ruling moral philosophy, and the only possible countermeasure is externalities but that depends on an effective government which is even more unlikely that asking for ethical behavior to corporations.

alpinisme 1y ago
That may be widely believed but there are plenty of government institutions that actually function well. Libraries are a good example. What’s more: the belief in govt “inefficiency” is one of the hardest to overcome factors that makes it hard to build good institutions, leading to a vicious cycle.
- conception 1y ago
  Exactly, people who think the government is inefficient has never worked at any company of scale ever. All large organizations are inefficient. A major problem of the US is just corruption. If people went to jail for things like congressional insider trading, we’d solve a lot of these issues.
  - jibe 1y ago
    All large organizations are inefficient. I agree, and that’s the case for dismantling as much of the federal government as possible - it is too big to work. Break up Apple, Google, Amazon, Washington DC.
    - conception 1y ago
      You’re forgetting the corollary - all small organizations are also inefficient, just at different things. It’s all trade offs - do you want everyone in your country to have a baseline education that can be relied on as a given but perhaps it suffers in its administration and effectiveness? Or are you OK with pockets of your country having tremendous quality of education and others having very poor quality, as an example.
pergadad 1y ago
Public utilities and services are the default and work well in the majority of developed countries. This is true for everything from local transport to water distribution. As the joke says "universal healthcare is so difficult to get right that only all developed countries except the US have managed to put it in place".

ninja3925 1y ago

> Just look at health insurance companies for a prime example: they make profit by denying claims Despite being from Europe, I find this to be a shocking and erroneous interpretation. Clearly, health insurances have the duty to allocate limited resources (“premiums”) across members. Denying and accepting claims is the mechanism to that end. Accepting all claims would increase premiums and reduce membership (by pricing people out). Would that an ideal state? Clearly not.

n4r9 1y ago
The point was not that all claims should be accepted. It's that adding a profit incentive to denials leads to worse outcomes.
Aurornis 1y ago
Healthcare debates in the United States are difficult because so many assume that insurers have very high profit margins and that arbitrarily denying claims is the reason they have high profit margins. If you look at the actual profit margins it’s low single digit percentages. You could eliminate profits altogether and virtually nothing would change. We even have non-profit insurers to look at It’s strange how the high prices of drugs and services aren’t drawing the ire of people who complain about costs. Drug prices are nearly 3X higher here than international averages and doctors here also earn a lot more with in many cases fewer restrictions on prescribing or offering services than in most EU countries. The meme that insurance company denials are generating huge profits comes mostly from the public murder of a health insurance CEO last year. For some reason people assumed that insurance companies and their profits must therefore be the core problem with high costs, without making the effort to see where the money actually goes in our health care system. As you said, there is no health care system which does not have approval processes, deny requests deemed unnecessary, require step therapy, and establish standards of care.
- klodolph 1y ago
  > If you look at the actual profit margins it’s low single digit percentages. You could eliminate profits altogether and virtually nothing would change. We even have non-profit insurers to look at Look at administrative overhead instead of profit. People understand that there are problems with the system, and maybe they’re misattributing the problems, sure.

Aurornis 1y ago

> Just look at health insurance companies for a prime example: they make profit by denying claims. This has been repeated so many times that I think people don’t understand just how small the profit margins are for health insurers. Low to middle single digit percentages. As low as 2-3% in recent years, and much lower than the average S&P 500 corporation. There are also non-profit insurance companies out there. Their rates are not appreciably different, as you’d expect after seeing how low the profit margins are in for-profit insurers. I also think people don’t realize that countries with nationalized health care also deny procedures, have pre-approval processes, require step therapy, and will not authorize procedures they don’t believe to be medically necessary or to have enough evidence. There is no health care system in the world which will simply approve and pay for every request. So while health insurer profit margins are convenient bogeyman, if you deleted their profits entirely from the system it wouldn’t move the needle on costs. It also wouldn’t open the floodgates for approving everything, because no health care system will allow unlimited services. The amount of excess and unnecessary care would be astronomically expensive. I do agree that we need a more robust system in place for ensuring that incorrect denials don’t happen, but health insurance profit margins are barely a blip on the overall cost of health care in the United States. It’s a combination of high prices for services, American’s unusually high utilization of health care services, and very high rates of drug prescribing that mostly contribute to the cost. I think most Americans would be surprised to discover that a lot of nations with nationalized health care would also be restrictive in their access to many services and prescription drugs. For as much as we talk about insurance companies denying claims, Americans still get far more services and prescriptions than most of their counterparts in other countries.

bestouff 1y ago
Whatever. Simply come to a decent EU country and see how much it costs you for a bad cold or a cancer. Then compare that to the same event in the US.
- itake 1y ago
  I've heard a horror stories about NHS and Canada's Medicare. Their systems are backed up, so treatment goes untreated for long periods of time. Presumably healthcare professionals are performing as many surgeries as they can per day. Just because one person was denied, doesn't mean another person isn't approved. For example, I'd rather get cancer in the USA than UK: https://www.politico.eu/article/cancer-europe-america-comparison/ https://www.politico.eu/article/cancer-europe-america-compar...

II2II 1y ago

I would argue that greed is the problem, not profit. One could argue that government policies are anything but altruistic. They fund public education because you need an educated workforce. They fund public health insurance because a healthy workforce is a productive workforce. You distribute the cost over the entire population. Both remove direct costs from employers (e.g. training and providing private health insurance). Both have a tendancy to reduce costs and improve consistency because you are working at a larger scale. It also creates order in society since people generally feel as though more of their needs are being met, and they feel less exploited. All of this contributes to profit both on a social scale and for individual businesses. Somewhere along the line people forgot the lessons of the 20th century. They forgot that profit goes beyond a line on the current financial statement. It also reflects long term interests.

fsckboy 1y ago
>I would argue that greed is the problem, not profit. I would point out that's precisely what the "private equity firm"--is that true or just a buzzword? no private equity group is taking this library private--is saying about the current library, that the greed of the unionized employees is running the library for their own benefit and at great cost to library and at the expense of the public, and it could be run more efficiently. So, you agree with them at least that much. >Somewhere along the line people forgot the lessons of the 20th century. They forgot that profit goes beyond a line on the current financial statement. huh? that wasn't "the lesson of the 20th century". if anything, the 20th century represents democracy and market capitalism's greatest joint achievement, with much less disease and starvation and much more freedom at the end vs the beginning. you live in one of the greatest times to be alive, and all you can do is complain. when and where from the past would you rather live out your life expectancy of half what it is now, coupled with no HN to bitch on?
energy123 1y ago
Human nature (greed) is never the problem, because it cannot be changed. Focus only on what can be changed. Design a system that manages human nature, pointing it in a direction that is beneficial, while taming its side effects. A denial of human nature is how you get authoritarian socialism with centralized planning, which leads to catastrophe because of the local knowledge problem, and because people have no private incentive to do anything. "Capitalism" is an incomplete first step towards a system which channels greed into something that's beneficial for all stakeholders. A profit-driven actor making their production more efficient to increase profits is a good thing for everyone. But capitalism is incomplete because the profit-motive can become pathological. Market failures are commonplace. The only solution that is proven to work is a mixed economy done right, with clever and lean regulations, and a government not influenced by money, and with the government stepping in occasionally to provide public goods that the market cannot, and with private actors otherwise free to make profits as long as they are not harming any third parties.

zx8080 1y ago

> A focus on profit is so frequently completely opposed to human wellbeing and a flourishing society. Not surprising considering the profit is taken from people in the society.

arjvik 1y ago

Is there a way to reward and incentivize improving human well being? Perhaps a society where all income comes from the government in proportion to how much one improves the overall well being of society? (Yes, it's difficult to measure this objectively, and even harder to agree on what the priorities for societal well being are)

01HNNWZ0MV43FF 1y ago
UBI would go a long ways to enforcing democracy. Money talks, so just give people money. Everything else is too abstract. We can't seem to encode justice into law but at least if everyone got UBI it would be harder to oppress poor people (half serious)
kortilla 1y ago
It’s not difficult, it’s impossible under freedom of religion and just independent thought generally. One person’s “well being” might be measured by how many wives and children you have. Another’s might be education level and physical fitness. Another’s could be financial independence. These all clash with each other in fundamentally incompatible ways.
PleasureBot 1y ago
Germany has a different structure for company ownership than the USA. Members representing relevant stakeholders (employees, the community, environment, etc.) must be present on the board and advocate for their interests.

deleted 1y ago

[deleted]

typewithrhythm 1y ago

Conceptually neoliberal societys do not have a strong way to seperate community and social goals from economic ones, because their very philosophy is that prosperity creates social improvement. Meanwhile everyone is living in low trust economic zones with no community observable, other than anonymous services.

BrenBarn 1y ago

Totally agree. I think another angle to look at it is not "a couple sectors" but "a certain scale", as suggested by your remark about how companies consolidate. When businesses are small and need every customer, they are motivated to do a good job at what they do, build goodwill, protect their reputation. The larger they become, the more they tend to work against their customers rather than for them. They cross multiple markets, making them less responsive to the demands of any one. They become "too big to fail". And so on. What we see in the modern era is a system in which success is defined as becoming large enough that your customers have no other option but to deal with you. That's not a healthy system.

leoedin 1y ago
You see that scale problem everywhere. Once a business has become large, it no longer cares about “small” costs like unused buildings. That’s basically the reason so many buildings in towns and cities can be left unused for decades. The impact it has on that town is often huge. But for the business, it’s just a small overhead. A small landlord couldn’t afford to leave their asset unproductive. A multinational conglomerate can. The death of local high streets is in part due to the unwillingness of landlords to actually rent their properties out for market rate.
- dmurray 1y ago
  I don't understand how massive corporations are both ruthless slash and burn cost-cutting profit optimizers and sloppy businessmen who don't care about the small things, even in aggregate. What's the economics of not renting out high street retail properties? There must be millions of them across the first world, with a theoretical annual rent roll in the 11 or 12 figures. Are they owned by a million multinational conglomerates foregoing a hundred grand each? In that case we are stretching the definition of "multinational conglomerate". Or are they concentrated in the hands of the same hundred companies? In that case they are each missing out on ten billion a year in opportunity. There isn't a company in the world where you couldn't make your name as Head of Global Unused Property managing ten billion a year of revenue. I don't have an answer for this either, but it must be more complicated than "they're all owned by multinationals who don't care about such small numbers" - the point of multinational companies is that those numbers are no longer small at scale.

burnt-resistor 1y ago

Public-private "partnerships" backed by private equity will always raise prices, cut costs arbitrarily, reduce service, take out loans, and saddle the organization with debt to pay themselves huge dividends before driving it into bankruptcy. This is what happens when corrupt, unregulated capitalism is allowed to run amok and have zero skin in the game except to extract maximum profit like vampires.

kortilla 1y ago

Health insurance isn’t a great example. Profits are capped relative to premium costs so denying claims isnt a good strategy. The only way denying claims can become a profit booster is to deny enough that premiums can be lowered enough to bring over more new members than was lost in revenue through the premium discount. So denied claims come from people shopping for the cheapest insurance coverage possible.

xucian 1y ago

how do we fight this?

chii 1y ago

> And with fewer competitors, it’s easier and easier for entrenched so the problem isn't with profit after all, it's with low competition? So what is causing the lack of competition in the sector? Why can't that problem be fixed?

sershe 1y ago

this narrative is basically a lie 1) Americans spend less than OECD average out of pocket as a percentage of healthcare costs. This is much larger in absolute terms but the multiplier - cost of healthcare is nearly entirely due to provider costs. 2) Health outcomes are really different between states despite having basically the same system. demographically controlled iirc outcomes are not different and sometimes better (e.g. japanese americans). 3) Insurance company profits are pretty low relative to cost of healthcare. while the bureaucracy is more expensive its not "catastrophically" by any means and iirc there are oecd countries with similar overhead although im too lazy to search on myvphone. 4) Rationing healthcare has to and does happen in all advanced economies. again modulo cost in the us, id rather it happen via money than government or inforrmal scarcity (like in Canada). 4a) Frankly while i dont have evidence for this 4a, lookinng at us spending by age (and eg the enormous money usg spends on kidney dialysis for people thay mostly just die in a few years anyway), I wonder if an important reason US providers are so expensive is, we ration limited supply properly for most people but then don't ration keeping a bedridden grandma alive for 6 more months at extreme cost, cause hey, the govt pays.

lesuorac 1y ago

> Just look at health insurance companies for a prime example: they make profit by denying claims. Ok but why do people pick those insurance companies? We see this across the board too and not just insurance companies. Governments low to pick the lowest bidder who then has massive cost overruns which has to put them above the second lowest bid in the end. Why is counter party risk never accounted for?

antisthenes 1y ago
> Ok but why do people pick those insurance companies? Because they are bundled with their job and most people don't have a choice?
- lesuorac 1y ago
  Does HR get their own health insurance?
  - pseudalopex 1y ago
    Do CEOs and CFOs report to HR? Are HR heads not rewarded for cutting costs? How would people in other departments react if HR alone got better health insurance?
    - lesuorac 1y ago
      My point is that if HR picks a company that'll deny their coverage then they also have to live with their decision as well as the rest of the employees who had no choice.
      - pseudalopex 1y ago
        My point was HR don't pick a company or don't pick them isolated from all other concerns.