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Comment by renewiltord | Hacker News Reader

Private equity goes where the money is. Nothing is magically non-exploitative just because it's done by a bunch of small businessmen instead of a private equity company. There's a reason why Private Equity bought so many dialysis clinics. There's a reason why they're doing this.

It's easy to scam the government out of money for this because a bunch of well-meaning "useful idiots" will say "pay whatever it takes; give them as much money as they need; it's for human lives!" and none of that is true. It's all about using different battalions to rent-seek on normal tax-paying Americans.

Tim Walz lost his hope for re-election over this but he's not the only one. In time we will discover a large array of healthcare scams and home-care and autism/child mental health are going to be near the top.

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Yes, as soon as I hit the "...children who are largely insured by Medicaid programs..." part of the article, I figured that this is happening because some PE firms ran the numbers and discovered they could use autistic kids to squeeze as much money from medicaid as possible.

If your dialysis clinics have the worst outcomes in the industrialised world, it should make you go hmmm.

And usually it's not a problem, of "Throwing more money at it", but lack of regulations and enforcing them.

That said, Physician Owned Clinics have better outcomes, there is no reason why that shouldn't be the standard model of operating them. Usually they have more moral scruples about worsening care for profit.

Also there is naturally more competition, if there are multiple small operators instead of only Fresenius Nephrocare or DaVita

https://www.cbsnews.com/texas/news/death-rates-at-u-s-dialys...

The dialysis clinics are bad and make all the money because it’s Medicare fraud dude. Well meaning morons say “whatever people need we should pay for them” not thinking for a second that some unscrupulous fuck is the one getting the money.

CBS say this then don't publish the data!

The data [https://www.transonic.com/renal-disease-in-us] says that kidney transplants for dialysis patients happen LESS frequently in the USA than in Europe, yet the survival rate is very close - 39% USA vs 41% Europe. This implies that dialysis in the USA is very close or _better_ quality than in Europe - as there is a large difference in transplant rates but only a small difference in survival rates.

Maybe the above data is wrong, but CBS don't seem to provide any better data

Your own link says

Survival rates for ESRD are higher in Europe than the U.S. This could be explained by the inferiority of national standards of care, a higher prevalence of patients with diabetes and differences in practice patterns.

Let's look at actual journals

For those with ESKD onset from 2004 to 2008, unadjusted 5-year survival of all patients with ESKD (treated with dialysis or transplantation) was 41% in the USA, 48% in Europe, and 60% in Japan, despite patients being 2–3 years older on average in Europe and Japan than in the USA, and Japan having very few transplant patients.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

The US had a much higher KRT incidence, prevalence, and mortality compared to Europe, and despite a higher kidney transplantation rate, a lower proportion of prevalent patients with a functioning graft.

https://pubmed.ncbi.nlm.nih.gov/38439701/

This does seem like a direct contradiction to me, but it’s also 2 decades old

The second paper has data from 2021, I've included the first one because it's from a top journal

Then yeah, this supercedes my point, seems I am wrong

We have something like this going on in Australia right now.

The NDIS is our disability welfare scheme, and it's costs have exploded as oversight has failed to keep pace with exploitative actors. Few questions asked welfare for our vulnerable would be nice, but sadly it doesn't look sustainable in most places.

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