i'd be curious about other metrics in addition to death rate...

- health adjusted quality of life metrics and the way they are impacted by various diagnoses

- healthspan metrics

- patient satisfaction

- employee satisfaction

Ultimately, capitalism is not necessarily at odds with providing efficient high qualty healthcare. But we have to decide what matters. If death rate were the only relevant metric, medicine would be practiced much differently.

There's a reason death rates are used to measure outcomes in things like crime prevention: it's harder to fudge reporting when there's a dead body.

Everything else you mentioned can be manipulated in bad faith, especially by a profit-motivated organization.

I agree, I don't think capitalism is inherently at odds with quality healthcare, and technically private equity isn't either but it certainly raises the chances. PE firms tend to be fairly parasitic with their investments - maybe that's fine for a restaurant chain but that sucks when you're dealing with lives (people or animals). I used to be in health insurance and you knew when there were nursing homes and clinics/faciltiies that were owned by PE. PE-owned nursing homes tend to have far more infractions against them, more elder abuse claims, and lower quality of life for the residents. You could say well PE buys up facilities that have room for improvement, which sometimes that's true, but in many times they seem to buy because (imo) they feel they can get by with lower regulatory enforcement so can cut costs and squeeze them. Sometimes they do buy or build higher-end senior living facilities but those are cash cows in their own way that you don't want to cut corners with.

> Ultimately, capitalism is not necessarily at odds with providing efficient high quality healthcare.

Um, yes it is?

First off, there is tension between "efficient" and "high quality". High quality in an environment with peaky demand requires over-resourcing during periods of lower demand, which is inefficient. The best way to resource for peaky demand curves is to run at 60-80% usage (i.e. 20-40% idle).

Health care has peaky demand curves. PE is going to optimize on efficiency therefore degrading peak demand performance, which is when quality matters the most.

Second, capitalism optimizes resources to maximize value capture. That's great when value capture is tied closely to value delivery, like you want a hamburger and you get a hamburger.

Not when value capture is diffusely tied to value delivery. You want a stable market economy with rule of law to protect your property and your contracts. While without this, nothing you own has any worth (making it the most valuable thing possible), the value of this is rarely delivered to you in discrete chunks.

What are you faffing on about? With no barriers, pure capitalism would consolidate healthcare into a full vertical and horizontal monopoly. This is basically what PE firms are doing, but indirectly.

Capital doesn't organize around any secondary metric but profit without being forced.

Employee satisfaction? Are you completely out of touch? Speak to any working professional in a PE owned hospital system. It's horrid, the worst, dystopian, soul diminishing.

Satisfaction only matters if there are other places you can go.

Patient satisfaction? It's already 'accept what we give you, pay what we demand, or you die' in rural areas or if you are poor/uninsured. People already avoid going to the doctor when they should because of this. What bizarre alternate world are you living in?

> Ultimately, capitalism is not necessarily at odds with providing efficient high qualty healthcare.

What would the situation look like where revenue is better directed to shareholders than to care?