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Comment by sbierwagen | Hacker News Reader

I mean, plenty of businesses have incentives maligned with society. Gas stations want you to burn more gasoline, not less. Hospitals want you to visit more often, and spend more each visit. Liquor stores want you to drink more alcohol. Etc etc.

Are hospitals predatory?

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Hospitals don't want you to visit more often. At least not in any healthy society. Hospitals that do prefer ill people over healthy people are indeed predatory and dangerous for a society to have, because it operates on very harmful incentives.

I guess this is the clearest case ever of why regulation is important. Good regulation provides businesses with incentives that help rather than harm society.

>Hospitals don't want you to visit more often. At least not in any healthy society

"Healthy" society is a weasel word here though: a qualifier that turns this into a "no true scotsman".

In this one, and most real societies, hospitals do want people to visit more often. Their incentives are geared towards that.

And not just "visit more often" -- hospitals (well, hospital execs, doctors, etc) want (and do) all kinds of things detrimental to society:

- to charge more for healthcare

- to add hidden charges

- to perform unneeded operations and treatments to make profit (even if the patient not only doesn't need them, but can be in danger from them)

- to prescribe drugs that the drug companies wine and dine them to promote, whether they're needed or not

And whole more besides.

E.g. https://www.scientificamerican.com/article/unnecessary-tests...

https://eu.usatoday.com/story/news/nation/2013/06/18/unneces...

http://discovermagazine.com/2018/apr/doctors-wined-and-dined

https://theconversation.com/whos-paying-for-lunch-heres-exac...

>"Healthy" society is a weasel word here though: a qualifier that turns this into a "no true scotsman". >In this one, and most real societies, hospitals do want people to visit more often. Their incentives are geared towards that.

This might be true, but I would expect citations. I might be biased, is only anecdote, but my experience around the world would single out USA as a place where this is predominant.

Besides, not all the hospital visits are equal, a clear example of how we can align the incentives are vaccination campaigns.

>This might be true, but I would expect citations. I might be biased, is only anecdote, but my experience around the world would single out USA as a place where this is predominant.

Sure, but most of the discussion on HN focuses on a USA context.

In my country for example, such incentives might not be predominant re: public healthcare (since the staff gets paid whether they have more patients or not), but they are with private practices.

Hospitals are extremely predatory. They're the number 1 cause of bankruptcy in the US, and that's not even including the extreme financial drain they cause through all those insane insurance premiums. The banks, facebook, apple, not even at&t can compete with hospitals in terms of the financial damage they've caused. It's funny how the media never seems to mention them?

Just adding here: gyms don't want you to use their equipment / facility to get healthier. Or at least many don't.

> Hospitals want you to visit more often

Maybe this is true in the US but not sure it's valid point in Europe where, given how the health system works, most of the time patients are actually a cost for the business hence less patients the better really.

Parent is talking on a profit-per-patient driven environment. Now where (e.g. due to welfare) a patient is a cost.

Hence the other arguments he made, about gas stations want you to burn more fuel, etc.

It's about how for-profit incentives of companies can be detrimental to society.

The way this sometimes works is that people want to do higher quality work than might be strictly necessary, and charge appropriately. That way you can feel proud of what you do (a quality job) and make money doing it.

Price-sensitive customers may feel differently.

Profit-taking hospitals are absolutely predatory.

It is not predatory to profit when both parties come out ahead, and we should not confuse organizational or financial structure of a company with the actual behavior of the company or its members.

The Surgery Center of Oklahoma[0][1], for instance, makes a profit while providing better, lower-cost treatments than traditional hospitals. And they actually have transparent pricing.

[0] https://surgerycenterok.com/ [1] https://reason.com/reasontv/2012/11/15/the-obamacare-revolt-...

Yes. The people there aren't, but the institutions by design are.

Do doctors set up people who suffer from chronic circulatory inflammation due to their diet / exercise regime with dieticians and psychiatrists that attempt to treat the root causes of their issues, or with a regimen of pills that make them feel like shit?

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