7 ms·

We already know that Private Equity kills people in the hospitals [1] and nursing homes [2] for profit. So why do we continue to allow them to operate Healthcar

• cogman10 10mo ago
  Because we have governments anemic to running anything or regulating any business. They are much more likely to continue shoveling cash into private businesses through subsidies then to want to setup and/or run the same business for a fraction of the cost.
  • tjwebbnorfolk 10mo ago
    The same one who just said PE isn't allowed to buy any more residential real estate? I hope they go after hospitals next.
    • cogman10 10mo ago
      > The same one who just said PE isn't allowed to buy any more residential real estate? We'll see. That was just an EO. That doesn't really have the force of law behind it. There's not a regulatory body (AFAIK) that would or could prevent PE from gobbling up a home. But if there's a route to stop it then I'm not opposed to it. PE buying essential goods and industries is bad for everyone.
      • tootie 10mo ago
        It wasn't even an EO. It was a tweet.
        • deleted 10mo ago
          [deleted]
        • gryfft 10mo ago
          The President's statements, and even unspoken thoughts, have the full force of law. This President, anyway-- I think the Supreme Court has a special criterion they use to determine whether Unitary Executive Theory should apply to a particular administration.
          • actionfromafar 10mo ago
            Yes, if admin == Republican.
      • thayne 10mo ago
        My impression is it was also mostly a publicity stunt.
    • wookmaster 10mo ago
      He says about 500 things a week and rarely followed through. They have gone after anyone yet so I wouldn't be thinking about "next"
      • AniseAbyss 10mo ago
        [dead]
    • refulgentis 10mo ago
      I’ve been hoping to meet one of the marks for the ol’ “tweet means he did it” thing in year 5. Hello!
    • sokoloff 10mo ago
      NB: “single family homes” not “residential real estate”
  • andy99 10mo ago
    Government is probably the worst actor to run healthcare facilities. It’s not that different from PE, except with more administrative bloat. I’d be curious to compare US PE run facilities with government run facilities in Canada. There is not an easy answer here, it basically a cost centre that whoever runs it, the welfare state is incentivized to spend as little as possible on it. PE is almost certainly a bad solution. If they can destroy a restaurant or other low impact business, I hate to think what they’d do to businesses that care for people. You’d get the healthcare equivalent of Burger King. But with government you get the equivalent of the DMV.
    • cogman10 10mo ago
      > I’d be curious to compare US PE run facilities with government run facilities in Canada. You don't have to do that, we have US government ran facilities. It's the VA. And if you look at the costs associated with the VA, they are much much cheaper than almost any private care [1]. And if you know a few vets, you know they almost universally love the VA. It's one of the best perks of serving in the military. [1] https://www.herc.research.va.gov/include/page.asp?ID=inpatient https://www.herc.research.va.gov/include/page.asp?ID=inpatie...
      • wisty 10mo ago
        Free market ideologues are too dumb to understand local minima. An ideal free market is a global minima (in theory). It's the best. A non-ideal free market (heavily subsidised and regulated) might be close (in parameter space) to a global minima, but might be highly suboptimal compared to a local minima.
        • messe 10mo ago
          It's not even that. Free markets by themselves (as implemented thus far) DO NOT ACCOUNT FOR EXTERNALITIES. I have yet to see reasonable fix to the tragedy of the commons in a free market situation, and that's one of the most basic things one is fucking introduced to when studying economics and game theory. Anybody who thinks health care is best served solely privately should have to pay to be diagnosed for something; either that or they've been failed in their privately funded education.
  • immibis 10mo ago
    Think the word that fits there is "allergic".
  • throwaway2037 10mo ago
    > Because we have governments anemic to running anything or regulating any business. This comment is weird to me. The US has one of the most effective environmental regulators in the world (EPA). The FAA and FDA are also excellent. The securities markets in the US are the global gold standard of regulation (SEC, etc.).
    • cogman10 10mo ago
      Certainly. These are institutions that have mostly been created during the progressive era of the US. The EPA (I believe) is the latest of these organizations. Since roughly Reagan, the US has been either fully dismantling, defunding, or privatizing these institutions. We've seen the FAA start to rely too heavily on the likes of Boeing to set regulation standards. The FDA has relied heavily on fees from private institutions to function and it's weakening due to that improper mixing has resulted in the likes of the Vioxx scandal. Medicare is a good example of this. Under Clinton, rather than expanding or reforming medicare he introduced a plan to allow private insurance companies to get government dollars (medicare part c).
      • throwaway2037 10mo ago
        > These are institutions that have mostly been created during the progressive era of the US. The EPA (I believe) is the latest of these organizations. Wiki tells me that the EPA was created by Richard Nixon in 1970. Also, it matters little when a regulatory body was created. It matters much more how it changes over time -- it is continously adapting to changes in our society and economy. For example, after the 2008 global financial crisis, securites markets regulators changes significantly to strengthen the financial system. > Since roughly Reagan, the US has been either fully dismantling, defunding, or privatizing these institutions. Clinton, Obama, and Biden were doing this? If so, please provide examples.
        • cogman10 10mo ago
          > Clinton, Obama, and Biden were doing this? If so, please provide examples. Yup. Primarily on the 3rd prong but, especially under Clinton, there was also significant defunding that went one. "The era of big government is over". Clinton did welfare reform, which added much stricter means testing and work requirements to welfare. The "reinventing government" program was literally a hack and slash on government agencies not unlike DOGE. The student loan reform reduced subsidies for students. He signed in the crime bill which enabled the building of private prisons and ramped up the US incarceration rates. And he created Medicare part C which created a route to send government funds to private insurers. Obama's signature bill, the ACA, was a giant handout to insurance companies in pretty much every way. By trying to force people into buying insurance and also subsidizing insurance purchases, it was a major gift to health insurers. Even the Medicaid expansion mostly resulted in private insurers getting more wealthy as most states implement Medicaid via a private insurance contractor. After the first midterm Obama got very little done mainly due to the republican's continuing the Newt Gingrich "we oppose everything you support" strategy and the filibuster. Biden was mostly business as usual, however both the infrastructure bill and the chips act can't be seen as anything other than just massive giveaways to private industry. The build back better act would have been the same had it passed.
• p-e-w 10mo ago
  Because between the 1970s and 1990s, Western nations decided that private operations should be the default for everything except where the law specifically requires state institutions, instead of the other way round. In many countries, essential services like hospitals, drinking water supply, airport security, schools, even prisons are now partially or fully privatized. It seems insane when you think about it, but that’s what your grandparents voted for.
  • messe 10mo ago
    A mix of public and private can work with proper regulation (especially when combined with state owned private companies). This article only refers to the US. This is the second time I've brought it up over the last week, but it'd be nice if the US and "the west" weren't constantly conflated. Not all of us have fucked over their citizens and spiraled into borderline dictatorships that are well on their way to becoming international pariahs as much as the US have.
    • immibis 10mo ago
      Everything suddenly makes a lot more sense once you realize the US is a developing country, one that happens to control the global money printer (due to a few accidents of history). It's the only developing country that is also "first-world" or "western", and unfortunately, also the most powerful of those.
  • c22 10mo ago
    How would this work the other way around? The state provides cheeseburgers and fidget spinners until someone writes a law requiring private industry to provide these things? Isn't there a sort of lack of freedom inherent in forcing people to get all their cheeseburgers from a single place?
    • nicoburns 10mo ago
      Yes, but there's also a lack of freedom inherent in denying people healthcare and other public services because they can't afford them.
• JumpCrisscross 10mo ago
  > why do we continue to allow them to operate Healthcare facilities? We don’t want to pay for them. When private equity is forced to sell, someone has to buy or the providers get shuttered. On the other hand, we’re clearly willing to blow the money and deficit on stupid stuff. But only if it goes boom, apparently.
  • lukev 10mo ago
    Who do you mean by "we", here? The only possible entities who could buy a company are either a bigger company, or private equity. That the leavings of a PE business are unattractive to either of them is not a surprise. That has nothing to do with what society at large (a better definition of "we") actually wants or needs.
    • JumpCrisscross 10mo ago
      > Who do you mean by "we", here? Voters, broadly and monolithically. > only possible entities who could buy a company are either a bigger company, or private equity Communities. Forcing PE to divest from healthcare would require setting up a lending facility communities can borrow from to buy back their healthcare infrastructure. (Or have the government just buy it outright.) I guess you could make it work as a window-dressing bill. Force PE to divest. Leave unsaid that you’re letting billionaires and family offices buy it up to continue the same shit. But actually solving the problem means ponying up cash to buy this stuff back. Even if it’s out of bankruptcy. (I’m not even touching the politics of paying PE and its lenders with public money.)
      • john01dav 10mo ago
        If you change rules to make the PE business model unprofitable, since it's in many ways toxic to society, you can result in them then needing to sell, for much less than they'd like most likely, or adapt and become less toxic.
        • JumpCrisscross 10mo ago
• cyanydeez 10mo ago
  Had a creepy interaction with Fraser. They absolutely did a marketing spiel and sounded nothing like a medical intervention. When you review the findings on the standard behavioral intervention, autism, on average requires 2.5 years of 40hr/week. Thats basically one persons job.
• MarkusAllen 10mo ago
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• john-h-k 10mo ago
  Your citation's statistics [1] actually says the exact opposite of your claim! It shows a -0.2pp DECREASE in in-hospital mortality, with no significant change on 7 or 30 day mortality. The authors suggest this could be due to: * selecting for healthier patients - the paper shows an average change of 0.1 years younger for patients. this is not significant! * transferring out sicker patients - 30 day mortality would show this (it doesn't), and the transfer rate does not change meaningfully So based on the evidence you have provided, private equity purchasing hospitals saves lives. Maybe that is wrong, but it is the conclusion of that evidence. They also don't claim PE is killing people in the conclusion; did you read the paper?
  • hermanzegerman 10mo ago
    The age difference was significant They've had more bloodstream infections, surgical infections, and falls. Everything which traces back to staff cuts and lack of hygiene. Also they dumped the complicated, and probably expensive cases to real hospitals In contrast, transfers to other acute care hospitals increased 12.2% at private equity hospitals compared with control hospitals
    • john-h-k 10mo ago
      A 1 month average age difference is not medically significant. They had more bloodstream infections yep. Surgical infections was NOT statistically significant. And again, mortality went down!! The “dumping cases” thing is incredibly suspicious. So they’re so motivated by money that they … don’t keep patients who would spend a lot? On top of that, the 30 day mortality doesn’t show an increase, which is what you’d see if they dumped deaths onto other hospitals.
      • hermanzegerman 10mo ago
        Medicare reimburses by DRG, which is a payment for the average cost patients with that diagnosis and comorbidities have. Usually those hospitals send the patients they expect to become to cost more than the DRG Reimbursement (Complications, too old, too many comorbidities) off to public hospitals. At least that's how it works in Germany. At the same time, they are very aggressive with upcoding their diagnoses to get more reimbursement.
• xnx 10mo ago
  In all these critiques, "private equity" is a stand-in for "capitalism" in general.