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

https://pluralistic.net/2025/11/13/patients-not-customers/
10•Refreeze5224•1h ago

Comments

bko•50m ago
> Property rights are America's state religion, and so market-oriented language is the holy catechism. But the things we value most highly aren't property, they cannot be bought or sold in markets, and describing them as property grossly devalues them. Think of human beings: murder isn't "theft of life" and kidnapping isn't "theft of children":

...

> To date, PE-owned nursing homes have stolen at least 160,000 lost life years

I'm glad the article starts with a kind of hysterical emotional anti-capitalist plea as it helps me determine the quality of the arguments to follow. Everything is vibes. No rationality or analysis.

getnormality•33m ago
I have slowly been coming around to an understanding that healthcare really is different due to the uniquely massive information asymmetries of doctors versus patients (and payors and everyone else), plus irremediable difficulties with market search or "comparison shopping". I appreciate that it may be bad to mix profit incentive into an industry that simply cannot operate as a real market. (That said, problems don't all evaporate the moment you take out profit incentive, and you probably introduce new problems as a side effect.)

These radical critiques that basically say "putting a monetary value on things that matter is fundamentally wrong" have made my progress much slower. I'm not here to hate on markets! They work great (and much better than collectivist alternatives) for a lot of things that we value greatly, like being able to feed ourselves. Selective sentimentality about the value of human life and human needs doesn't bring anything to this conversation. We all care about human life and children and agree that they can't be bought and sold. But when you're asking someone to do something for someone else, you have to compensate them, and you have to compensate them enough for it to be worth their while given their alternatives. So you have to put an economically-driven monetary value on it in some way or other. There are no perfect benevolent angels we can call down from the heavens to be our doctors.

bko•13m ago
I think comparison shopping works great, even with health related things. When you pay out of pocket, like for Lasik or cosmetic surgery, it works. And most medical expenses are non-emergency.

There exists asymmetry in all markets. I don't know anything about cars, but I take it to a mechanic. I get a quote, and ask around and eventually some mutually beneficial trade happens.

The market aspects of healthcare work well but so much of it is not a market and the third party payer system. Try asking a doctor what somethings costs, they will look at you like you have two heads. They have no clue.

The fact is healthcare today is not a market, not even close. Things that are a market generally work well (supermarkets, mechanics, cosmetic surgery). We should have healthcare become more of a market. As just one example a healthcare provider cannot open up in many states without a "certificate of need"

> Certificate of need (CON) laws are state regulatory mechanisms for approving major capital expenditures and projects for certain health care facilities. In a state with a CON program, a health planning agency or other entity must approve the creation of new health care facilities or the expansion of an existing facility’s services in a specified area. CON programs primarily aim to control health care costs by restricting duplicative services and determining whether new capital expenditures meet a community need.

Imagine to open a restaurant you would need to go to some board and argue how your restaurant is needed in this neighborhood, or the idea that opening a restaurant would INCREASE restaurant prices by offering duplicative services. Madness!

https://www.ncsl.org/health/certificate-of-need-state-laws

Refreeze5224•28m ago
Feel free to argue against what he's saying instead of his tone. If you think he's wrong, which he isn't, feel free to ague that point instead of pretend that healthcare being for profit isn't incredibly harmful, and that the US is not laps behind every other developed nation.
sharts•2m ago
Isn’t capitalism and free-market thinking also vibes? Most economics is irrational, but assumes rational. Therefore even most economic analysis is silly.

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