<story><title>Some private equity firms are furious over a paper in a dermatology journal</title><url>https://www.nytimes.com/2018/10/26/health/private-equity-dermatology.html</url></story><parent_chain><item><author>thaumasiotes</author><text>I mean, this is close to being right, but it&amp;#x27;s wrong in every one of the details.&lt;p&gt;Crassus didn&amp;#x27;t own the fire department. Crassus owned a bunch of slaves who he had trained to put out fires.&lt;p&gt;Crassus didn&amp;#x27;t charge for extinguishing fires. If your house was on fire, Crassus took his team and negotiated &lt;i&gt;to buy your house&lt;/i&gt;. If you sold it to him, he&amp;#x27;d put out the fire. There was no flow of money from you to Crassus under any circumstances. (But he could get a low price, because the value of your house was constantly dropping while it burned.)&lt;p&gt;In imperial times, private firefighting groups were illegal since they were viewed as a potential source of rebellion. (Using your own slaves to put out fires on your own property was of course fully legal.) It&amp;#x27;s in my mind that Crassus benefited from similar laws, but he was active during the Republic. Maybe someone else knows more about the precise timings.</text></item><item><author>LaundroMat</author><text>In ancient Rome, Crassus owned the fire department. When there was a home on fire, Crassus would negotiate the price for extinguishing the fire with the owners or tenants.&lt;p&gt;Plus ça change...</text></item><item><author>duxup</author><text>There was an NPR (I think it was NPR) story about how medical helicopter rides have skyrocketed in cost.&lt;p&gt;The issue was a lot of private equity folks realized that you could just get in the market and if you didn&amp;#x27;t get enough rides... you just cranked up the price and went after individuals who where hardly in a position to shop around when they needed the ride.&lt;p&gt;Now there is an excess of medical helicopters, solution?   Crank up the price...</text></item><item><author>aaavl2821</author><text>This isn&amp;#x27;t discussed much, but the healthcare provider industry has traditionally been a major sector of interest for private equity.  Hospital companies like HCA, dental clinics, ambulatory surgery centers, etc.&lt;p&gt;Healthcare providers are attractive to private equity 1) because of stable, non-cyclical cash flow, 2) benefits to scale (ie better negotiating leverage with payers), 3) ability to easily increase revenue at small clinics by &amp;quot;optimizing&amp;quot; billing (ie use more lucrative codes for the same procedure) and practice management (optimizing procedure mix and scheduling) and 4) regulatory protection -- local monopolies enjoy durable economic advantages and often are politically entrenched as healthcare providers are major employers&lt;p&gt;These factors aren&amp;#x27;t limited to private equity backed healthcare, though.  Even non-profits take advantage of these things (sutter health in the bay area is an example).  If you&amp;#x27;re looking for why US healthcare is so expensive, this isn&amp;#x27;t a bad place to start</text></item></parent_chain><comment><author>ErikVandeWater</author><text>&amp;gt; Crassus didn&amp;#x27;t own the fire department. Crassus owned a bunch of slaves who he had trained to put out fires.&lt;p&gt;That sounds like he literally owned the fire department? It was just made up of slaves.&lt;p&gt;Otherwise I really found what you said very interesting!</text></comment>
<story><title>Some private equity firms are furious over a paper in a dermatology journal</title><url>https://www.nytimes.com/2018/10/26/health/private-equity-dermatology.html</url></story><parent_chain><item><author>thaumasiotes</author><text>I mean, this is close to being right, but it&amp;#x27;s wrong in every one of the details.&lt;p&gt;Crassus didn&amp;#x27;t own the fire department. Crassus owned a bunch of slaves who he had trained to put out fires.&lt;p&gt;Crassus didn&amp;#x27;t charge for extinguishing fires. If your house was on fire, Crassus took his team and negotiated &lt;i&gt;to buy your house&lt;/i&gt;. If you sold it to him, he&amp;#x27;d put out the fire. There was no flow of money from you to Crassus under any circumstances. (But he could get a low price, because the value of your house was constantly dropping while it burned.)&lt;p&gt;In imperial times, private firefighting groups were illegal since they were viewed as a potential source of rebellion. (Using your own slaves to put out fires on your own property was of course fully legal.) It&amp;#x27;s in my mind that Crassus benefited from similar laws, but he was active during the Republic. Maybe someone else knows more about the precise timings.</text></item><item><author>LaundroMat</author><text>In ancient Rome, Crassus owned the fire department. When there was a home on fire, Crassus would negotiate the price for extinguishing the fire with the owners or tenants.&lt;p&gt;Plus ça change...</text></item><item><author>duxup</author><text>There was an NPR (I think it was NPR) story about how medical helicopter rides have skyrocketed in cost.&lt;p&gt;The issue was a lot of private equity folks realized that you could just get in the market and if you didn&amp;#x27;t get enough rides... you just cranked up the price and went after individuals who where hardly in a position to shop around when they needed the ride.&lt;p&gt;Now there is an excess of medical helicopters, solution?   Crank up the price...</text></item><item><author>aaavl2821</author><text>This isn&amp;#x27;t discussed much, but the healthcare provider industry has traditionally been a major sector of interest for private equity.  Hospital companies like HCA, dental clinics, ambulatory surgery centers, etc.&lt;p&gt;Healthcare providers are attractive to private equity 1) because of stable, non-cyclical cash flow, 2) benefits to scale (ie better negotiating leverage with payers), 3) ability to easily increase revenue at small clinics by &amp;quot;optimizing&amp;quot; billing (ie use more lucrative codes for the same procedure) and practice management (optimizing procedure mix and scheduling) and 4) regulatory protection -- local monopolies enjoy durable economic advantages and often are politically entrenched as healthcare providers are major employers&lt;p&gt;These factors aren&amp;#x27;t limited to private equity backed healthcare, though.  Even non-profits take advantage of these things (sutter health in the bay area is an example).  If you&amp;#x27;re looking for why US healthcare is so expensive, this isn&amp;#x27;t a bad place to start</text></item></parent_chain><comment><author>evgen</author><text>Crassus would also negotiate deals with neighboring houses that were in danger if the fire spread.  In densely-packed Rome a fire two or three houses down could suddenly make continuing to own your little piece of property a risky venture.</text></comment>