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Comment by anon-sre-srm | Hacker News Reader

That's the problem. The doctors should form employee owned co-ops and be sure profiteering administrators and suits aren't the ones running things.

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Well, despite that physician-owned hospitals have better outcomes than profit-above-all-else hospitals run by MBAs, Congress outlawed future physician-owned hospitals in the Affordable Care Act (Obamacare).

actually, the problem is that Congress continues to LOWER physician reimbursement, but RAISE hospital reimbursement. When I became a surgeon in 2002, medicare paid $600 for me to take out a gallbladder. I had to pay my overhead (50%) so my take-home was $300. Today, in 2024, after price reductions, medicare pays $600.

That is why I have to be employed. I guarantee that after 22 years, office expenditures (rent, salaries, supplies, health insurance) would eat up the remaining $300. So taking care of Medicare patients would be charity. Medicare is 60% of my practice. Private insurance is 25%. Medicaid is 10% and unfunded is 5%.

That is basically scenario #2 (which is common), but for whatever reason they haven’t been very successful at pushing back against some of the changes that cause these issues. I don’t have much insight to offer there since I’m not at the negotiating table there.

I mean I think the answer is that good doctors do form employee-owned co-ops, which are often very successful and establish a great deal of trust in their community, but then when the time comes for them to retire they very understandably cash out and sell to the private organizations that proceed to run them for profit first.

I've been playing with the idea for a while that any time a company uses its name, it has to disclose its ownership (first the company at the top of the chain, then the ownership structure of that company). So like for example the company name "Gerber" would have to always be coupled with "owned by Nestle, a publicly traded company.", and "Dave Franklin, a Dentist in your Community You can Trust" would have to be coupled with "Owned by Private Equity Incorporated, mostly owned by pension funds".

This would make it easier to keep track of if the same company is just screwing you over and over again with different faces, while still allowing some value to remain to brands that are consistently good for customers.

You’d just end up with shell companies with vague names obfuscating that they are actually part of “ACME global megacorp”

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