How, exactly, is private equity responsible for our medical system and our massive government budget problems. Please explain to me step by step like I'm stupid.
Not the guy you asked, but PE focuses on short-term profits via high-debt acquisitions, cost-cutting, and price increases. In the context of healthcare, for example, this means higher costs for both out-of-pocket and government payers, fewer staff and lower quality of care, and, in some cases, even closure altogether due to the acquisition debt (which was dumped onto the acquired org itself) pushing the org into bankruptcy (of course only after the PE firm has squeezed all the juice possible out).
>The long and short: In 2010, private equity firm Cerberus Capital Management purchased Caritas Christi Health Care, a struggling eastern Massachusetts hospital system, from the Archdiocese of Boston, converting it from non-profit to for-profit and rebranding it as Steward Health Care. In 2016, after years of continued financial instability, Steward signed a sale-leaseback agreement with Medical Properties Trust (MPT), selling the land and buildings occupied by its hospitals to the real estate investment trust then leasing them back. Steward made $1.25 billion from the agreement—enough to steady its financial footing, pay off Cerberus, and fund a growth spree. The next year, the company purchased 26 more hospitals across the country. But with the agreement came what many viewed as inflated rents.
There is a new doc on Netflix called "Country Doctor" which follows a doctor who works in a very rural area, it shows what happens when the hospital goes through another round of being sold off to a new firm and the difficult access of the county.
Others have pointed out how PE has degraded the medical system. The debt crisis I referred to is the private credit crisis, though no doubt private equity has played a key lobbying role in creating our national debt crisis as well. Regarding private debt, Jeffrey Gundlach sums it up:
"'This is starting to show up to be the problem that I've been referencing… that private credit and private equity, frankly, is being borrowed from private equity. It's sold on a volatility argument, primarily," Gundlach added. "Maybe there's some excess return for your illiquidity that you can get, but it's largely a volatility argument.'
Illiquidity could turn paper losses into real ones, Gundlach cautioned, pointing to the kind of liquidity squeeze that worsened the 2008 financial crisis, when investors were unable to meet capital calls."
And here’s a ChatGPT summary of it for the TLDR crowd:
Private equity ownership of hospitals and medical practices is linked to worse patient outcomes, higher prices, and weakened physician autonomy. The paper argues that PE’s standard playbook — heavy debt loading, cost-cutting, consolidation, and short-term profit extraction — is fundamentally misaligned with long-term medical care. Case studies like Hahnemann University Hospital show how sale-leasebacks and aggressive financial engineering can push essential hospitals into collapse. Consolidation of physician groups reduces competition and raises prices for patients and employers, while staff cuts and reduced investment correlate with lower care quality. The author calls for stronger antitrust scrutiny, transparency of ownership, and limits on practices such as asset-stripping to prevent further harm in the healthcare system.
"Private Equity's next victim..." From the people who brought you America's medical system, and looming debt crisis.
How, exactly, is private equity responsible for our medical system and our massive government budget problems. Please explain to me step by step like I'm stupid.
Not the guy you asked, but PE focuses on short-term profits via high-debt acquisitions, cost-cutting, and price increases. In the context of healthcare, for example, this means higher costs for both out-of-pocket and government payers, fewer staff and lower quality of care, and, in some cases, even closure altogether due to the acquisition debt (which was dumped onto the acquired org itself) pushing the org into bankruptcy (of course only after the PE firm has squeezed all the juice possible out).
https://hsph.harvard.edu/news/private-equitys-appetite-for-h...
>The long and short: In 2010, private equity firm Cerberus Capital Management purchased Caritas Christi Health Care, a struggling eastern Massachusetts hospital system, from the Archdiocese of Boston, converting it from non-profit to for-profit and rebranding it as Steward Health Care. In 2016, after years of continued financial instability, Steward signed a sale-leaseback agreement with Medical Properties Trust (MPT), selling the land and buildings occupied by its hospitals to the real estate investment trust then leasing them back. Steward made $1.25 billion from the agreement—enough to steady its financial footing, pay off Cerberus, and fund a growth spree. The next year, the company purchased 26 more hospitals across the country. But with the agreement came what many viewed as inflated rents.
Then read below "Consequences of cost-cutting".
There is a new doc on Netflix called "Country Doctor" which follows a doctor who works in a very rural area, it shows what happens when the hospital goes through another round of being sold off to a new firm and the difficult access of the county.
Others have pointed out how PE has degraded the medical system. The debt crisis I referred to is the private credit crisis, though no doubt private equity has played a key lobbying role in creating our national debt crisis as well. Regarding private debt, Jeffrey Gundlach sums it up:
"'This is starting to show up to be the problem that I've been referencing… that private credit and private equity, frankly, is being borrowed from private equity. It's sold on a volatility argument, primarily," Gundlach added. "Maybe there's some excess return for your illiquidity that you can get, but it's largely a volatility argument.'
Illiquidity could turn paper losses into real ones, Gundlach cautioned, pointing to the kind of liquidity squeeze that worsened the 2008 financial crisis, when investors were unable to meet capital calls."
https://www.foxbusiness.com/markets/jeffrey-gundlach-says-cr...
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Here’s a neat article written for the Missouri Medicine Journal that covers it: https://pmc.ncbi.nlm.nih.gov/articles/PMC11482842/
And here’s a ChatGPT summary of it for the TLDR crowd:
Private equity ownership of hospitals and medical practices is linked to worse patient outcomes, higher prices, and weakened physician autonomy. The paper argues that PE’s standard playbook — heavy debt loading, cost-cutting, consolidation, and short-term profit extraction — is fundamentally misaligned with long-term medical care. Case studies like Hahnemann University Hospital show how sale-leasebacks and aggressive financial engineering can push essential hospitals into collapse. Consolidation of physician groups reduces competition and raises prices for patients and employers, while staff cuts and reduced investment correlate with lower care quality. The author calls for stronger antitrust scrutiny, transparency of ownership, and limits on practices such as asset-stripping to prevent further harm in the healthcare system.