FYI - there are already a few states that don't allow companies to enforce such draconian noncompetes.

Moving to California is better than killing yourself most of the time.

I like the German non-compete requirements (by law): max non-compete length is 24 months. Non-competes need to be reimbursed at half the last salary. The non-compete also needs to be specific to a real competition scenario (e.g. you taking your clients with you). For a job like being a generic doctor which any doctor could do, that would likely fail.

If the non-compete is so broad that it makes you unemployable that also makes it void.

Private equity is cancer. It honestly should be illegal, particularly to buy a company with a loan and then strip-mine the assets to pay back that loan.

Private equity looks for "pricing power". This just means "inelastic demand". So housing, vets, healthcare, food and utilities are great targets because you can't opt out of basic needs. Healthcare (and vets) have the added layer that PE tends to buy all the practices in an area at the same time so there's no competition. And, like you say, they sign all the medical providers with these big contracts with onerous non-competes

Those non-competes, while onerous, tend to be regional. The region can be large however but if you moved (which, admittedly, most people don't want to do) then you could practice medicine elsewhere.

Here are two big ways PE is trying to corner these markets with mixed success:

1. Some states (eg Oregon) have laws that forbid companies from "practicing medicine" so when Apollo came and tried to buy their way into emergency care (so the hospitals fired the physician-owned emergency medicine group that had been running it for decades), they try this convoluted corporate structure where there's a company that ostensibly owns the new healthcare operation and it has some doctor placed as the chief but really it's a Trojan horse for the PE firm. So far, judges in Oregon have rejected this end-run around the law; and

2. Envision Healthcare was a massive PE failure because of a law change. Here's how it worked. Whatever insurance you have will have in-network and out-of-network providers. In a hospital environment you generally have little control over the various providers who see you. This has led to some surprises where, say, the anesthesiologist for your surgery might be out-of-network while your surgeion was in-network. The surgeon is getting an in-network fee of $8000 but the out-of-network anesthesioligist is charging $100,000. Unscrupulous doctors would evngage in revenuemaxxing by intentionally bringing in an out-of-network provider then splitting the much higher fee rather than using the residents in the hospital, which were essentially "free".

That was Envision's entire business model: surprise out-of-network billing. Then in 2021, the No Surprises Act was passed that basically outlawed this practice. It forced hospitals to only receive in-network rates for things like this. And the entire $6.5B purchase of Envision imploded.

This is partially why I get so angry when people try and defend PE as a concept. It's entirely parasitic. It's not even theoretically making a business more efficient. It's just hiking prices in a way where people have no choice. That's it.

The interesting part is that the PE firm will try and exit by IPOing the "restructured" company, which will only last a few years before the complicated debt structure implodes, a bit like subprime loans. A textbook structure is to "sell" all the real estate to a holding company and that's not listed and then you have complciated leaseback contracts that only keep going up in rent.

One of favorite "fun" facts about healthcare is when passing the Affordable Care Act, somebody snuck in a provision that made physician-owned hospitals illegal. Who? Nobody really knows as best as I can tell. It just made it into the final bill. Someobody argued doctors would have an unfair advantage or something. Who? Insurance companies.

Honestly, this entire system needs to be burned to the ground, Boudicca style.

> PE

Name and shame.

By some logic:

* If they want to tell someone personally what to do or not to do, is some form of employment.

* If it is not paid, it can be considered slavery.

* It is usually possible to quit jobs.

Executive level non-competes are probably the most damaging for the overall economy though.

If there's a market-dominating company, and execs are allowed to leave said company, start a competitor, get some investor dollars behind them, then start poaching employees from the old company, the market can have a really viable competitor quite quickly.

Without that ability, little monopolies spring up throughout the economy and use their size to crush upstarts, under-compensate their employees, overcharge their customers, and squeeze their suppliers.

Banning non-competes is an absolute requirement for free-market capitalism to function properly.

I'm a firm believer in this as well. You want to enforce a noncompete? Great. You have to pay me as much as what I was earning (plus benefits), possibly more, for as long as you want to enforce it. That amount should probably go up 50%+ per year too.

Easier to do when there's paper to scratch.

> Sadly Amazon has been known to enforce its 18-month NC in WA state

I'm darkly-amused by how this really makes Amazon sound like a quasi-governmental entity.

AFAICT a lawsuit (Burns v. Amazon) on that is ongoing.

Washington State also passed a non-compete ban that will take effect July 2027.

It’s nice to be rich I guess

i rarely use ai, however i must constantly sift through ai blog posts like this one to find actual communication. should i leave the internet to win the game against ai? well i did the next best thing and got a nokia brick phone, yet facebook still knows how to recommend those i meet in real life!! i tried not playing but im still in the game. does that mean the only way i can win is to kill myself?