Posts Tagged ‘health care’
“I analogize it to sex. You realize there were certain things you shouldn’t do, but the urge is there and you can’t resist.”*…
The estimable Cory Doctorow on the incursion of private equity into health care…
As someone who writes a lot of fiction about corporate crime, I naturally end up spending a lot of time being angry about corporate crime. It’s pretty goddamned enraging. But the fiction writer in me is especially upset at how cartoonishly evil the perps are – routinely doing things that I couldn’t ever get away with putting in a novel.
Beyond a doubt, the most cartoonishly evil characters are the private equity looters. And the most cartoonishly evil private equity looters are the ones who get involved in health care.
Writing for The American Prospect, Maureen Tcacik details a national scandal: the collapse of PE-backed hospital chain Steward Health, a company that bought and looted hospitals up and down the country, starving them of everything from heart valves to prescription paper, ripping off suppliers, doctors and nurses, and callously exposing patients to deadly risk…
[There follows an illuminating– and truly terrifying (backed up sewage in the wards; bats colonizing hospital floors; stiffed employees and vendors)– an unpacking of Steward’s deeds and a location of them in the larger landscape of private equity.]
… But despite Steward’s increasingly furious creditors and its decaying facilities, the company remains bullish on its ability to continue operations. Medical Properties Trust – the real estate investment trust that is nominally a separate company from Steward – recently hosted a conference call to reassure Wall Street investors that it would be a going concern. When a Bank of America analyst asked MPT’s CFO how this could possibly be, given the facility’s dire condition and Steward’s degraded state, the CFO blithely assured him that the company would get bailouts: “We own hospitals no one wants to see closed.”
That’s the thing about PE and health-care. The looters who buy out every health-care facility in a region understand that this makes them too big to fail: no matter how dangerous the companies they drain become, local governments will continue to prop them up. Look at dialysis, a market that’s been cornered by private equity rollups. Today, if you need this lifesaving therapy, there’s a good chance that every accessible facility is owned by a private equity fund that has fired all its qualified staff and ceased sterilizing its needles. Otherwise healthy people who visit these clinics sometimes die due to operator error. But they chug along, because no dialysis clinics is worse that “dialysis clinics where unqualified sadists sometimes kill you with dirty needles“
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The PE sector spent more than a trillion dollars over the past decade buying up healthcare companies, and it has trillions more in “dry powder” allocated for further medical acquisitions. Why not? As the CFO of Medical Properties Trust told that Bank of America analyst last week, when you “own hospitals no one wants to see closed.” you literally can’t fail, no matter how many people you murder.
The PE sector is a reminder that the crimes people commit for money far outstrip the crimes they commit for ideology. Even the most ideological killers are horrified by the murders their profit-motivated colleagues commit.
Last year, Tkacic wrote about the history of IG Farben, the German company that built Monowitz, a private slave-labor camp up the road from Auschwitz to make the materiel it was gouging Hitler’s Wehrmacht on…
Farben bought the cheapest possible slaves from Auschwitz, preferentially sourcing women and children. These slaves were worked to death at a rate that put Auschwitz’s wholesale murder in the shade. Farben’s slaves died an average of just three months after starting work at Monowitz. The situation was so abominable, so unconscionable, that the SS officers who provided outsource guard-labor to Monowitz actually wrote to Berlin to complain about the cruelty.
The Nuremberg trials are famous for the Nazi officers who insisted that they were “just following order” but were nonetheless executed for their crimes. 24 Farben executives were also tried at Nuremberg, where they offered a very different defense: “We had a fiduciary duty to our shareholders to maximize our profits.” 19 of the 24 were acquitted on that basis.
PE is committed to an ideology that is far worse than any form of racial animus or other bias. As a sector, it is committed to profit above all other values. As a result, its brutality knows no bounds, no decency, no compassion. Even the worst crimes we commit for hate are nothing compared to the crimes we commit for greed…
“When private equity destroys your hospital,” from @doctorow. Eminently worth reading in full– and following his newsletter (from whence this comes).
* David Rubenstein, co-founder and co-chairman of the private equity giant The Carlyle Group, at a Harvard Business School Conference
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As we rethink returns, we might recall that it was on this date in 1944 that Louis Buchalter (AKA Lepke Buchalter, AKA Louis Lepke) was executed in the electric Chair at Sing Sing. One of the premier labor racketeers in New York City in the 1930s, he is better remembered as the creator (in 1929) and overseer (thereafter) of an efficient system for performing mob hits; while Buchalter never named it, it became known in the press as “Murder, Inc.“
The Cosa Nostra mobsters wanted to insulate themselves from any connection to these murders. Buchalter’s partner, mobster Albert Anastasia, would relay a contract request from the Cosa Nostra to Buchalter. In turn, Buchalter would assign the job to Jewish and Italian street gang members from Brooklyn.
None of these contract killers had any connections with the major crime families. If they were caught, they could not implicate their Cosa Nostra employers in the crimes. Buchalter used the same killers for his own murder contracts. The Murder, Inc., killers were soon completing jobs all over the country for their mobster bosses…
source
Murder, Inc. was believed to be responsible for as many as 1,000 contract killings before it was exposed in 1941, and Buchalter was finally charged and convicted of murder that same year.
“The welfare and the future of our societies depend on our capacity to remain mobilized so as to improve the health of every mother and child”*…
Preparing for a world post Roe v Wade…
The red states poised to ban or severely limit abortion already tend to have limited access to health care, poor health outcomes and fewer safety net programs in place for mothers and children.
If the U.S. Supreme Court overturns Roe v. Wade, as it’s expected to, the ensuing increase in births will likely leave families in tough circumstances and strain systems that are already hanging by a thread.
“What we’re facing as a country is hundreds of thousands of births, probably disproportionately located in the states that have been most limited in what they do for pregnant women, infants and children. So this is the great paradox that we are dealing with,” said Sara Rosenbaum, a health law and policy professor at George Washington University. “We have not ever designed these programs for a world without Roe,” she added. “You need a child welfare system, the likes of which we’ve never seen.”…
A growing shortage of obstetricians, higher maternal mortality rates and worse health care outcomes generally, increased pressure on U.S. foster and adoption systems— it all bodes ill…
We know from focus on health outcomes that kids born into poverty, kids born into unstable social circumstances, tend to have higher incidence of early onset chronic diseases,” Shannon said. “We also know that when those children are raised in unstable circumstances and have to be cared for in foster care, the outcomes there are really sobering.
Richard Shannon, chief quality officer for Duke Health
“Red states aren’t prepared for a post-Roe baby boom,” from Caitlin Owens (@caitlinnowens) in @axios.
* Jean Ping
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As we contemplate care, we might sending healing birthday greetings to Thomas Huckle Weller; he was born on this date in 1915. A virologist, he developed a technique for cultivating poliomyelitis viruses in a test tube, using a combination of human embryonic skin and muscle tissue– which enabled the study of the virus “in the test tube,” a procedure that led to the development of polio vaccines. He was awarded the Nobel Prize in Physiology or Medicine in 1954.
“Well, I was born in a small town”*…
… which is, new federal designations now dictate, definitely not an urban area…
Hundreds of urban areas in the U.S. are becoming rural, but it’s not because people are leaving.
It’s just that the U.S. Census Bureau is changing the definition of an urban area. Under the new criteria, more than 1,300 small cities, towns and villages designated urban a decade ago would be considered rural.
That matters because urban and rural areas qualify for different types of federal funding. Some communities worry the change could affect health clinics in rural areas as well as transportation and education funding from federal programs…
Groups like the American Hospital Association say the changes, which are the biggest being made to the definitions in decades, could cause problems for people who need medical care in rural areas…
Different federal programs use different definitions of urban and rural, and some communities qualify for rural funding for some programs and not others. But any changes “will have significant implications for many groups and communities,” said Kenneth Johnson, a senior demographer at the University of New Hampshire who studies rural issues.
“Another likely concern for many rural communities is that if many existing urban areas are redefined as rural, competition for the limited rural funds will increase,” Johnson said…
The difference a designation can make: “100s of US urban areas will become rural with new criteria,” from @AP.
[image above: source]
* John Mellencamp, “Small Town”
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As we contemplate categories and their consequences, we might recall that it was on this date in 1965, at Magoo’s Pizza in (the then small town of) Menlo Park, CA, that Phil Lesh attended a performance of a band then known as The Warlocks. High on acid, he enjoyed it so much that he danced by himself in front of the bandstand. The Warlock’s leader, Jerry Garcia, cornered him and announced, “Hey, man-you’re going to be the bass player in this band”… and so the fundamental line-up of what became The Grateful Dead was set.
“By temporarily disrupting the order of the brain, a new order forms. And that order may have incredible value at either the level of mental health and psychology or the level of creativity.”*…
But, Zoe Cormier warns, if the means of that constructive disruption are industrialized and turned into aggressively-marketed products, we could be in for trouble…
Welcome to the strange new world of “psychedelic capitalism,” where dozens of start-ups have already raised millions (and in some cases billions) of dollars to commercialize psilocybin (the psychedelic ingredient in magic mushrooms), DMT (found in the Amazonian brew ayahuasca), mescaline (peyote’s active component), and LSD—despite the fact that all of these “classic psychedelics” are still ranked as Schedule I drugs under the federal Controlled Substances Act. Manufacturing any of these drugs without a license can still land you a long prison sentence. But marketing one, even though they all remain illegal and none have passed all the clinical trials required for approval? That can make you a millionaire…
The days when mind-bending psychedelics were seen as appealing only to drug dealers, nut jobs, and hippies are over. Today, serious-minded people interested in randomized controlled trials and stock valuations are leading the charge.
The “psychedelic renaissance” we’ve awaited for half a century—the promised era when acid, shrooms, and peyote would be brought back into legitimate research and legal access—is finally here. But will it turn out to be worth the wait? Or the hype?
Because it’s not like we ever stopped enjoying them: In the West, hippies, scientists, “healers,” and others have used psychedelics continuously for seven decades. And before we got our hands on them, Indigenous cultures used psychedelics for thousands of years as ritual sacraments. Now dozens of start-ups want to standardize, commercialize, alter, patent, and market these ancient compounds—and they stand to make a fortune doing so.
Will old-school profit-centered tactics bring down decades of dogged work by activists, scientists, and reformers to have these drugs reassessed for their virtues? Will we experience another nasty, research-smothering backlash?…
The profiteers have arrived; get ready for Psychedelics Inc.: “The Brave New World of Legalized Psychedelics Is Already Here,” from @zoecormier @thenation.
* Michael Pollan, in conversation with Tim Ferriss on Ferriss’ blog
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As we tune in, we might spare a thought for Ellen Swallow Richards; she died on this date in 1911. The first female student admitted to MIT, she became its first female faculty member. A chemist, she did pioneering work in sanitary engineering, but is best remembered for her experimental research in domestic science, which laid the foundation for the new science of home economics, of which she is considered founder. She was one of the first ecofeminists, believing that women’s work within the home was not just vital to the economy, but also a critical aspect of our relationship to the earth.
“We are healthy only to the extent that our ideas are humane”*…
For three days, thousands of uninsured Americans converge on the Wise County [Virginia] Fairgrounds for the largest pop-up clinic in the country. Most are poor, many are in pain, but all have faith in a level of care that neither the government nor private industry can provide…
A story both heart-warming and horrifying: “Tent Revival.”
* Kurt Vonnegut, Breakfast of Champions
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As we tend to the needy, we might send instructive birthday greetings to William Sanford “Bill” Nye; he was born on this date in 1955. A mechanical engineer turned actor, science educator, and television presenter, he is best known as the host of the PBS children’s science show Bill Nye the Science Guy (1993–1998), and for his many subsequent appearances in popular media.
Nye was greatly influenced by Carl Sagan, with whom he studied astronomy at Cornell University. He began his career with Boeing, in Seattle, designing hydraulic systems, from the early to mid 1980s. From 1986-91, he created and developed the Science Guy persona for local radio and TV, while eking out a spartan existence as a stand-up comedian. But in 1992. he made a pilot program for the local PBS station, attracted underwriters, and launched what became a five-year national PBS series, Bill Nye the Science Guy. Since then he has appeared in other TV science programs and as a guest expert on TV shows, continuing his quest to make science accessible to the public. He currently serves as CEO of The Planetary Society.
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