45 Comments

Capitalism stands in the way of equitable health care in America. We are a laughing stock among European democracies. I feel for the doctors who are caught between hospitals, insurance companies, and Medicaire. We can do better than this.

Expand full comment

Excellent and true article. Ive watched it all unfold during my 35plus years as a physician with the takeover of corporate and profit driven medicine. Venture capital and private equity have no place in healthcare, yet here we are.

Yes, my hospital system has the highest Covid admits of the entire pandemic right now. Care givers are burned out and disillusioned and the anti-science, political divide is responsible. We could have the greatest healthcare in the world. We have the resources. We have the commitment from health care professionals. Unfortunately we have the worst political system, driven by money and profit. Americans are suffering because of our political system. The demise of voter rights last night has sent many into despair. But we can’t give up. Yes it CAN get worse.

Expand full comment
founding

You need to understand that our US healthcare system is a major competitive disadvantage in the global economy. You cannot fight this issue on moral grounds but on business competitive grounds.

Healthcare like utilities needs regulation by setting baseline standards and setting profit rates.

Expand full comment

The failure to expand Medicaid in North Carolina is a huge reason why rural hospitals have closed.

Expand full comment

So well said. Hospitals are also shoving patients out the door too quickly. An elderly friend was sent home too soon after her stroke and couldn't even walk or eat without assistance. She relapsed and was back in for another week to more fully recover. I'm old enough to remember when hospitals didn't do this...didn't send mothers home the day after delivery or a couple of hours after surgery. Patient care is based on the hospital's finances, not the patient's needs. Will we ever be able to go back to hospitals being public entities like 30-40 years ago?

Expand full comment

The US is a predatory capitalist environment with insufficient regulation because the predators own the legislatures. In Missouri, the 20-year gerrymandered one party legislature is owned by the insurance industry and today yet another bill is being crafted that will gut the funding for Medicaid expansion that the voters just approved via a hard-won ballot initiative and that would help keep rural hospitals open. Another bill kills ballot initiatives altogether, the only way Missouri voters have had to circumvent the one party legislature. Having just lost a court challenge to their defunding of Medicaid expansion they keep trying to persuade voters that we didn’t know what we were voting for. You couldn’t make this shit up.

Expand full comment

I have to wonder - is there any thing that private equity does that is good - the firms only seem to exist to prey on weak businesses and then kill them.

Expand full comment

I appreciate that you’re tackling this, as lack of choice impacts in other ways, too. There are two primary providers in my metro area, and my health care coverage is only in network at the one that is religious, and moreso the last few years. They used to have a “sin room” for family planning before. Now they just wont do it unless there’s a separate medical reason for a type of care. And apparently this has been increasing at Catholic-run care facilities that many patients have to go to due to insurance or access requirements.

Expand full comment

Cerberus committed extortion -- right there -- out in the open.

Expand full comment

Thank you for a well-researched article on this subject. I've been telling people to consider why hospitals were so close to the edge in the first place. While I believe strongly in vaccination, blaming unvaccinated people for the shortage of hospital beds ignores the underlying problem (and it's mean).

Expand full comment

No one should be surprised by the actions of a financial firm named Cerberus

Expand full comment

Very valuable reporting, thank you!

This problem is not only limited to rapacious capitalists, however. I spoke recently with my friends in the Netherlands, who enjoy universal health care. They tell me that hospitals are overwhelmed there too, but one of the reasons is because bureaucrats reduced the number of ICU beds to six for all of the south of Holland. Therefore, draconian rules about gathering and even going outdoors have been implemented on and off throughout the pandemic.

I see this as a fundamental error in understanding public health and an over-reliance on a business-oriented world view. Human beings are biological organisms, not running shoes. The "laws" of supply and demand that may apply very well to factory-made objects simply don't apply to people.

Expand full comment

I've always thought that it is immoral to make profit off of illness. Somewhere I read that it until the 70s there were regulations (laws?) that constrained hospitals from making money. Is that true?

Expand full comment

All healthcare institutions that deliver care directly to patients should be non-for-profit entities. But we don't actually have a healthcare system. We have a wealthcare system masquerading as one. It's too fragile to handle even a pandemic with a relatively low death rate. What happens when one comes along with a fatality rate of (say) 5%? I don't want to be around to find out.

Expand full comment

We’ve seen this issue up close nationally since the pandemic rage began, and the problem can be as much about beds as equipment like ventilators or qualified medical personnel. I don’t discount the problem, the politics, the economy, the Capitalism, etc., but I’d like to take up the topic of variants. I’m healthy, vaxxed and boosted, and while I had relaxed my mask usage, since Omicron I wear N95’s exclusively and always when I’m in an indoor public place. With the rise of Omicron, I have heard it’s not as serious as Delta. I have also heard and read that we don’t track the Covid variant hospital patients have, we aren’t contact tracing, nor are we distinguishing patients in the hospital for reasons other than Covid who then test positive - they’re just lumped in with people admitted due to Covid. I try to stay in tune with the issues that create doubt in the science, and these things do. How can we accurately say anything about Covid hospitalizations, spreading, severity, etc., if we don’t have more precise data?

Expand full comment

Many years ago, I read that "extra" hospital beds were being eliminated. I thought then, and I think now, that that was a really stupid move; what would we do if we needed more beds than we had? If all we can think about is money, we deserve what we get. Trouble is, the ones who suffer most are not the greedy ones squeezing the hospitals dry and then throwing them away, like the CEO in this article. He will always be able to find a hospital bed if he needs one.

Expand full comment