[HN Gopher] Profit-Obsessed Private Equity Is Now Dominating the...
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       Profit-Obsessed Private Equity Is Now Dominating the US Hospice
       System
        
       Author : pessimizer
       Score  : 33 points
       Date   : 2023-05-28 21:55 UTC (1 hours ago)
        
 (HTM) web link (jacobin.com)
 (TXT) w3m dump (jacobin.com)
        
       | version_five wrote:
       | I agree that this is concerning. I'd also say that the only thing
       | worse than PE running these would be the government running them
       | (see Canada). This is a natural role for religious organizations
       | (I'm not religious) and I don't know what most logically could
       | take their place that would actually care about people.
       | (Companies sort of have to due to competition, but after profits,
       | governments don't have to care at all). Ideally incentivizing
       | nonprofits to run these and disencentivizing for profit ownership
       | it probably most reasonable.
        
         | ska wrote:
         | > PE running these would be the government running them (see
         | Canada).
         | 
         | I know there were a lot of problems in the Canadian system
         | caused by or exposed by Covid, but weren't the worst of them
         | private companies in some sort of private-public deal not, as
         | your wording suggests, the government running them?
         | 
         | I may be misremembering. Somewhat like the US state-to-state
         | variability, province-to-province is quite different also I
         | suspect.
        
         | morkalork wrote:
         | I adamantly disagree, there are a number of religious sects
         | that follow a "life at all costs" line of belief and which
         | effectively tortures people by prolonging their suffering. It
         | is awful and has no place in a modern and compassionate
         | society.
        
         | funac wrote:
         | I'm not sure religious organizations (or, at least, the
         | religious organizations which would realistically be involved)
         | have a very good record of running institutions that involve
         | significant power asymmetries
        
       | madballster wrote:
       | While that sounds concerning, I have to question the underlying
       | thesis: Does private ownership always short-change customers,
       | like the subtitle insinuates? "hospice agencies are now for-
       | profit, putting profit maximization over patient well-being."
       | 
       | Do hotels or restaurants put profit maximization over customer
       | well-being? If they do, they will be out of business rather soon.
       | If the hospices have competition and comparability (for patients
       | or their loved ones) then the same mechanism should work over
       | time.
        
         | RobotToaster wrote:
         | >Does private ownership always short-change customers, like the
         | subtitle insinuates?
         | 
         | Corporations literally only have one goal, to generate the
         | maximum profit for shareholders.
         | 
         | By definition profit is money not spent on making services
         | better.
        
         | nologic01 wrote:
         | Profit maximization is the overarching objective. Customer
         | dissatisfaction, complaints, fines etc is only a problem if it
         | starts eroding profits.
         | 
         | Businesses have developed countless mechanisms to be able to
         | survive client backlash.
         | 
         | Oligopolies and cartels is a major trick. Competition
         | highlights poor performers. Not good for business.
         | 
         | Uninformed customers is another biggie. Hence, fight consumer
         | protection mechanisms, limit disclosure etc.
         | 
         | Finally, regulatory capture, eg fixing the rules of the game so
         | that legally there is no recourse.
         | 
         | So, yeah, in some ideal world in which economists win Nobel
         | prizes arguing the optimality of the corporate structure you'd
         | be right.
         | 
         | We dont live in that ideal world.
         | 
         | That sad thing is that, obviously, profit maximizing private
         | enterprize, just like the public sector itself, are
         | indispensable organizational units.
         | 
         | Until we learn to tame them we will be paying the price.
        
         | efields wrote:
         | Hotels do this, and it's a race to the bottom. The hotel
         | experience has gotten so bad people accept going days without
         | turndown service now.
        
           | throwaway5959 wrote:
           | That's thankfully turning around. We were just in a hotel for
           | a few days and they offered to turndown our room each night
           | which we declined as we don't really make a mess and it was
           | only two nights.
        
           | version_five wrote:
           | Would you like to "make a green choice" and have our staff
           | ignore your dying loved one for the day in exchange for a $5
           | Starbucks gift card?
        
           | mym1990 wrote:
           | Or maybe people want to be left alone in the evening?
        
         | chasing wrote:
         | > Do hotels or restaurants put profit maximization over
         | customer well-being? If they do, they will be out of business
         | rather soon. If the hospices have competition and comparability
         | (for patients or their loved ones) then the same mechanism
         | should work over time.
         | 
         | This is not how it works and is why the government sometimes
         | needs to step in with regulations. As a founder in the
         | healthcare space once said to me: "I like regulations because
         | it means I can do the right thing for my customers and not have
         | to worry about competing with people who are willing to do harm
         | because it's more profitable." Companies need to be able to
         | compete. Some will do better. Some worse. But the government
         | needs to establish the baseline rules so society as a whole
         | isn't harmed.
        
         | ska wrote:
         | "private equity" is not the same as "private ownership", no?
        
         | omginternets wrote:
         | >I have to question the underlying thesis: Does private
         | ownership always short-change customers, like the subtitle
         | insinuates?
         | 
         | What a bizarre misrendering of the _actual_ question, which is
         | "does private equity systematically undermine the quality of
         | healthcare?"
        
       | howard941 wrote:
       | Literally "vulture capitalism."
        
       | hammock wrote:
       | Kind of ironic to note that the world is upside down right now.
       | 
       | Public companies, which are regulated precisely to protect the
       | financial interests of shareholders, are forgoing profits for the
       | sake of their ESG scores.
       | 
       | Meanwhile, private equity, which is not regulated in the same way
       | and theoretically could be more easily managed towards objectives
       | other than profit, are smeared as "profit obsessed."
       | 
       | Wild times
        
       | oldstrangers wrote:
       | Housing: Check
       | 
       | Veterinarians: Check
       | 
       | Healthcare: Check
       | 
       | Education: Check
       | 
       | Hospice? Check
       | 
       | Cool.
        
         | toomuchtodo wrote:
         | Funeral Homes: https://kffhealthnews.org/news/article/funeral-
         | homes-private...
         | 
         | Defense: https://responsiblestatecraft.org/2023/03/22/as-
         | private-equi...
         | 
         | Adult content: https://techcrunch.com/2023/03/16/pornhub-owner-
         | mindgeek-sol...
         | 
         | Matt Stoller has lots of quality writing on the topic:
         | 
         | https://mattstoller.substack.com/p/closing-down-the-billiona...
         | 
         | https://mattstoller.substack.com/p/why-private-equity-should...
        
         | candiddevmike wrote:
         | Gotta find new industries to shuffle around all of their debt:
         | https://www.spglobal.com/marketintelligence/en/news-insights...
        
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       (page generated 2023-05-28 23:00 UTC)