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Revealing the dark truth about the impact of predatory private equity firms on American health care.Private equity (PE) firms pervade all aspects of our modern lives. Unlike other corporations, which generally manufacture products or provide services, they leverage considerable debt and other people's money to buy and sell businesses with the sole aim of earning supersized profits in the shortest time possible. With a voracious appetite and trillions of dollars at its disposal, the private equity industry is now buying everything from your opioid treatment center to that helicopter that helps swoop you up from a car crash site. It may even control how and when you can get your kidney dialysis. In Ethically Challenged, Laura Katz Olson describes how PE firms are gobbling up physician and dental practices; home care and hospice agencies; substance abuse, eating disorder, and autism services; urgent care facilities; and emergency medical transportation. With a sharp eye on cost and quality of care, Olson investigates the PE industry's impact on these essential services. She explains how PE firms pile up massive debt on their investment targets and how they bleed these enterprises with assorted fees and dividends for themselves. Throughout, she argues that public pension funds, which provide the preponderance of equity for PE buyouts, tend to ignore the pesky fact that their money may be undermining the very health care system their workers and retirees rely on.Weaving together insights from interviews with business owners and experts, newspaper articles, purchased data sets, and industry publications, Olson offers a unique perspective and appreciation of the significance of PE investments in health care. The first book to comprehensively address private equity and health care, Ethically Challenged raises the curtain on an industry notorious for its secrecy, exposing the nefarious side of its maneuvers.
In 1965, the United States government enacted legislation to provide low-income individuals with quality health care and related services. Initially viewed as the friendless stepchild of Medicare, Medicaid has grown exponentially since its inception, becoming a formidable force of its own. Funded jointly by the national government and each of the fifty states, the program is now the fourth most expensive item in the federal budget and the second largest category of spending for almost every state. Now, under the new, historic health care reform legislation, Medicaid is scheduled to include sixteen million more people.Laura Katz Olson, an expert on health, aging, and long-term care policy, unravels the multifaceted and perplexing puzzle of Medicaid with respect to those who invest in and benefit from the program. Assessing the social, political, and economic dynamics that have shaped Medicaid for almost half a century, she helps readers of all backgrounds understand the entrenched and powerful interests woven into the system that have been instrumental in swelling costs and holding elected officials hostage. Addressing such fundamental questions as whether patients receive good care and whether Medicaid meets the needs of the low-income population it is supposed to serve, Olson evaluates the extent to which the program is an appropriate foundation for health care reform.
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