At some point hopefully the US will catch up to other developed countries and introduced some much needed legislation so that is no longer the case.

fortunately, people make decisions outside of the Capitalism framework all the time.. those people include Doctors themselves. Think of Capitalism as a force of gravity in the system, but not the only one. Oversimplifying "america" mostly does not penetrate the topic as a real world system IMHO

This doesn’t happen as often for the same reason that startups would rather flare out than build a sustainable business: greed.

Most people would rather get rich quickly by selling out, instead of putting in effort to get rewarded far in the future.

Vertical orientation, so the hold outs still need to source per meds and foods and supplies from somewhere? Mega pet co owns the whole stack.

those 2 can only handle so many people... the rest are going to be screwed over by the PE companies

Theoretically, if those two firms are good at their jobs & also good at marketing (including referrals), then yes sure.

Realistically, 75% of professionals aren't worth their salt & so many people will just continue going to the PE firm controlled places since switching won't get them any better service & the 2 hold out firms in this scenario would pragmatically raise their prices.

The market can stay irrational longer than you can remain solvent. Yes eventually customers will go to better firms who will beat out the short sighted competition, but that could take years and there's no guarantee your firm will survive to see that day. A risk free lump of cash in hand right now is tough to pass up. Even if you are personally willing to take the risk, other stakeholders like stockowners, partners, or key employees may not. Indeed seizing the disgruntled customers after they become fed up doesn't actually require you to remain in business during the dark times - you could start a new firm with a clean slate, optimized for the situation that exists then with a war chest filled by the very PE firms that demonstrated to your customers how valuable you really are.

The eight (owned by some group that owns 800) can undercut the two on price until they go out of business. The eight could refuse to deal with suppliers that deal with the two. The eight can exclusively license products and procedures within the area, which the two would not be allowed to sell. The eight could pour a lot of money into local advertising, and start rumors about the other two to be picked up in the papers. The eight could award itself certifications and awards that are denied to the two, because the 800 represent a lot of pressure in the industry.

Or they could play dirty tricks. I think the previous is what they would be expected to do, and if you were an investor you might be able to sue them if they didn't.

It's an information asymmetry problem. If people knew which business were PE owned they would avoid them. This problem often happens when the cost of services is charged after delivery.

"private equity buys a company and drives it to shit."

Allow me to introduce you to VMware. It was bought out by Broadcom. That sounds like a tech firm buying a tech firm. It isn't really.

Broadcom is (not really) run by Robert Redford from the film "Pretty Woman", except this asset stripping exercise is rather more unpleasant than even his efforts.

VMware used to have a flourishing eco system. It managed to largely throw off plagiarism threats from when it was ESX vs ESXi. It was basically Linux (Redhat) with knobs on and fuck you freetards but here's a freebie version that we have cobbled together.

Anyway.

I was a VMware fanboi for roughly 25 years and now I am not. I was also a Windows (MS) fanboi too for some decades. Can't be arsed these days but I will.

Dealing with Windows and VMware is really unpleasant these days.

In my experience in my city [Portland, OR, US], PE owns most of the large clinics (NW VCA, BluePearl, Banfield). There are still a lot of smaller vets, but it's harder to get an appointment with them and most don't do urgent care/24hr emergency or have an app where you can do scheduling.

- In an emergency/urgent care situation, you can't really do a price comparison/shop - The pricing is opaque until they you receive the service. Even in routine/non-emergency situations, you get a quote for the services often 20-30 minutes into your appointment, even for annual exams, so it's pretty obnoxious to switch services at that point. - FWIU, Banfield and BluePearl both have a strategy where have lower cost exams to get patients in the door, but then make that up in super high testing/drug fees, e.g. a $300 UTI test that labs charge $30-100 and 10x upcharges on antibiotics readily available from Chewy/neighborhood pharmacies.

PE-owned vet clinics are cheaper due to economies of scale, and that's all that matters for most people.

I wish I could remember where I heard this, it's from some NPR podcast like Freakonimics or This American Life. Dentists would normally sell their private practice to an up-and-coming dentist that they know, but recent graduates are so mired in debt that they can't really afford the loan to buy a practice, so PE firms end up buying instead.

Edit:

> DUBNER: We did a series on private-equity consolidation in the pet-care industry, and we found a lot of problems there for employees and consumers. But we also learned something that seems to apply to a lot of the human healthcare industry. If you look at nursing homes, doctor’s offices, dentists offices, what we heard is that the founders of these offices and companies, when it’s time to retire, they might prefer to sell to one of their junior partners. That’s what often happened before private equity was around. But now those junior partners have so much debt from medical school or veterinary school or whatever that they can’t afford to buy the practice. So the only likely buyer is an outside investor like a private-equity firm. The P.E. firm is satisfying a real need there, but the resulting roll-ups or consolidations are often worse for existing employees and worse for consumers. Do you have any thoughts for how that might work differently?

https://freakonomics.com/podcast/the-biden-policy-that-trump...

Yes, it's definitely a sign of increasing inequality, on at least three fronts.

On the high side, there's loads of money sloshing around with—especially since the end of ZIRP—no "safe" place to put it. They "need" ways to guarantee high returns over relatively short periods in order to justify their continued access to a never-ending supply of yachts that have other yachts docked inside them; vulture capitalism is a reliable way to do that for people with absolutely no scruples or understanding of (or care about) long-term effects.

On the low side, much like DangitBobby noted, there's much less money available to either buy the business of someone interested in retiring and passing it along, or to start your own.

The third side is that moneyed interests have captured government to an unprecedented degree—even before the current administration came in, with its "burn down everything that helps people and hand the ashes to the wealthy to sift through for loose change" policies. All the protections that should be stopping private equity from doing these things are reliant on government to step in and actually impose meaningful penalties for harming people and small businesses, and it has been systemically incapable of doing so for far too long.