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Comment by cmsonger | Hacker News Reader

It maybe is obvious, or maybe it's controversial, but patients will never be put before profits by for profit corporations.

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You know, my wife holds the contract for occupational therapy services for the school district we're in, which is fairly remote. When she picks me up from work, the drive home is mainly her venting about how no one in the district seems to care about the kids. She routinely underbills and works crazy hours (I know she underbills because she documents her hours on the timesheet I designed for her). As an example, a couple days ago, I got the following text:

"We're going to Thai for dinner with the social worker so I can meet this girl's mom and schedule a home visit. She doesn't have a phone so we're meeting her at her work. They live in a container."

The previous contract awardee was a shell company that charged the district the same per-hour rate for services, but so vastly underpaid their therapist (by a factor of ~7) that she quit and my wife refused to work for them. So no children got services the remainder of that year, until the district worked out my wife's award.

Now, my wife's business is set up as an S-corp, so I guess she's a terrible person?

Is it obvious? I went to a fancy Japanese dinner last night. It was, obviously, a for-profit venture. At any point during that dinner, was anyone in the restaurant worried about the restaurant putting its "profits" above its patrons?

They weren't worried about it, but it was happening anyway.

I doubt the restaurant was a monopoly with literal powers of life, death, and bankruptcy over its patrons.

Why do other life-or-death markets --- the markets for food, say, or for housing and clothing --- manage to function effectively as markets? Why do we give section 8 vouchers to people to afford private housing instead of continuing to build housing projects, and SNAP benefits instead of government cheese? If anything, those other markets are more critical to life and death than health care, which is needed situationally.

Because message boards are a fertile breeding ground for fundamental attribution fallacies, I'll lay my cards on the table here and point out that I'm an activist Democrat and health care is, after public schools (which I am not in favor of privatizing), one of my most important motivating policy concerns. My problem isn't that I think conservatives are right about health insurance; it's that the countervailing arguments don't cohere.

Your argument is that a nonprofit Japanese restaurant could have delivered a better experience to me?

No, my argument is that "putting profits before customers" is a nonsensical thing to worry about.

This is pretty much the same argument that you make sidethread.

I'd wager a nonprofit Japanese restaurant could have provided your meal at a lower cost.

Would it have been the same meal, cooked by people with the same level of talent, served with the same care? "Profit" is not just a disposable line item.

How? Why doesn't anyone open a nonprofit restaurant and outcompete the for-profit ones?

Clearly, because profit-seeking infiltrators would sneak in and corrupt the whole affair.

Greedy insurers don’t pay your restaurant bill and thus do not control the quality of service (by squeezing restaurant owners for every penny they can save)

Agreed, which is why for profit companies should be kept as far away from healthcare as possible.

Are you taking into account that health care is being delivered in most western European countries by for-profit doctors, clinics and hospitals? (the UK being the big exception)

Also the U.K. is not one of the better systems out there. I'd rather have the French system (minimal public + private mix), Sweden (minimal federal mandated controlled by their provinces), or German (similar to Obama-care).

I don't hear any U.S. politicians who are really talking about reforming health care. How about tort reform? Patents? Cost transparency? No, all anyone talks about is how the federal government should get more involved, and everyone knows that lobbyist run the federal government, i.e. remember how the people representatives in congress didn't even have time to read the ACA?

How does this distinguish healthcare from anything else?

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