For-profit healthcare is the problem, not (just) private equity | Hacker News Reader

For-profit healthcare is the problem, not (just) private equity

pluralistic.net

39 pointsRefreeze522429 comments

Having worked at UNH and also having them and later UMR (owned by UNH) and now being insured by a non-public company, I can tell you the difference is huge. UNH is for profit through and through, quarterly reports are all that matter, and squeezing subscribers and providers is the result. It's disgusting and I'm pretty embarrassed to have worked for them at all because I was with a different company that was privately held and while their ethics were compromised, too, it was nothing at all like what I saw at UNH. There's no reason to have for profit, publicly traded health insurers, it doesn't need to be a thing.

No, government subsidies to for-profit healthcare is the problem.

As with every other subsidized sector, they balloon the price when there is an unlimited supply of funding to pay for it.

As opposed to a consumer focused sector where the prices are dictated by what the consumer can afford.

Why not both? Combining profit and health care creates a literal death cult.

This is ridiculous. A consumer doesn't want to die. Life saving "medical products" can be too expensive even with completely honest and well intentioned pricing. The whole point of the system is good people want to pool resources to enable purchasing these "medical products" to save lives. Pooling resources is subsidizing others, government or otherwise. Removing that is an impossibility.

This type of article allows people to indulge in righteous indignation and feel morally superior to the dirty capitalists — but it largely misses the point. The excessive spending in our healthcare system is mostly for treating chronic conditions caused by lifestyle issues: substance abuse, over eating, lack of exercise, junk food, lack of sleep, etc. Taking profits out of the system won't solve that fundamental problem. Other countries with socialized healthcare systems are perhaps more efficient and cost effective but they're facing similar systemic problems as their populations age, just on a longer time horizon.

We can probably take costs out too. Crazy that it costs $1500 to go to a sleepy ER and get 20 minutes of attention from a PA. And then the hospital bills you.

The problem I have with this line of thinking is that food is also pretty necessary for human survival, yet we've got a vibrant for-profit market that provides it, plus government subsidies to provide for those who cannot afford it (constantly creeping anticompetitive schemes, and autocratic fascists' attempts to withhold said subsidies, notwithstanding)

Boiling down the problems with healthcare being "for-profit" is like blaming an infection on the bacteria and calling it a day. In reality the bacteria have only been allowed to fester due to deeper problems.

I'd say the real problem is this industry has used regulations, both government and shared corporate "policy", to except themselves from most standard forms of accountability and market (aka patient) responsiveness. What other industry cannot tell you how much something costs ahead of time, and operates by sending you an arbitrary bill after the fact that is still fraudulent with amounts of 3-4x the actual prices? What other industry prevents new competitors from opening without a "certificate of need" ? What other industry is allowed to negotiate amongst itself to blatantly fix prices ? What other industry has had a lauded attempt at reform that included making patronizing that industry mandatory ?!

This certainly isn't a call to blindly "eliminate regulations", as history has shown that kind of thing mostly eliminates remaining checks while not going anywhere near the regulations that actually need reform (which are a lot of entrenched industry wide "business practices" at this point). But rather these are the terms we need to be thinking in rather than knee jerk blaming "profit".

The first strong move toward any system better than the status quo is universal price transparency.

You can grow your own food. You can't perform your own cataract surgery and you can't make your own vaccines.

As to your analogy, yes, the root cause of the infection is bacteria. Yes, there are supporting factors, like the open wound that allowed the bacteria in, or a weakened immune system that allowed it to flourish. But when you're treating an infection that's already out of control, you focus on eradicating the bacteria. You also clean the wound and boost the immune system if possible, but those are secondary measures.

In the case of healthcare, "for-profit" is the root cause. There will still be corruption and capture and psycho nurses, but those are wounds that can be fixed or suffered one at a time. Whereas the for-profit aspect of healthcare is a metastasized cancer that no amount of surgery can cure. We might need all kinds of treatments but we have to address the root cause as well.

Do you see the ability to grow your own food as being a strong check on grocery prices? To me, it's the many competing grocery stores, a few or even many different brands in each, and prices labeled up front. If anything, healthcare seems easier to go your own way - simply by going without.

Also can we agree that one of the main reasons doctors go to work every day is for the paycheck? That's a form of profit, right?

(And I'm certainly not making this argument to inductively argue that all profit is good! In fact, like bacteria, outsized profits call attention to where the system has problems. But we do need to get the boundary conditions correct)

Commodity production is. All of it.

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