emancipated patients: GET POLITICALLY ACTIVE

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get (politically) active

By Patrick Neustatter, MD

Sometimes being an emancipated patient means more than just having all those virtues that safeguard your personal wellbeing, and that are cleverly encompassed in the term 'e' patient (equipped, enabled, empowered and engaged).

Sometimes it means being politically active and lobbying our hopeless politicians about legislative strategies that affect the healthcare industry.

This is the case in what I see as an unhealthy trend, enabled, and encouraged by financial and tax policies, that are damaging your healthcare.

Gutting Healthcare to Feed Shareholders I refer to the corporate takeover of healthcare which is happening all around.

Private equity firms are buying up medical facilities of all kinds and tweaking them to make them as profitable as possible then selling them off at huge profits - a move condemned as "fundamentally incompatible with sound healthcare that serves patients" says a report form the American Antitrust Institute.

A recent article in Mother Jones talking about private equity companies that "stalk and gut" other companies and are part of a "corporate world that grew accustomed to valuing shareholders over everyone else" really brought this to my attention.

Unfortunately, these predators seem to see the healthcare industry as fertile ground - to the detriment of those served.

A study by the Becker Friedman Institute for example, showed "private equity ownership increases the shortterm mortality of nursing home residents by 10 per cent" due to lowered nursing staff to patient ratios, and "diversion of patient care funding to private equity owners.’” Other reports accuse private equity funds of buying dental practices and incentivizing an increase in the volume of procedures, regardless of necessity.

They've taken over companies providing staff to healthcare facilities more than a third of the country's emergency rooms rely on private equity firms. They own travel-nurse companies (which have had massive leverage with staff shortages associated with COVID) so Aya Healthcare, for example, is advertising travel nurses the possibility of earning $6,950 a week). One of my pet-peeves is the massive proliferation of urgent cares which are a private equity favorite.

Though convenient, they syphon off "the gravy," the easy, profitable business from primary care practices (trivial illnesses, minor injuries, and minor procedures all of which are disproportionately profitable) making it harder for primary care practices to survive - when what is needed is old fashioned primary care practices with established doctor-patient partnerships to oversee health and prevention on a longterm basis.

But it's an uphill battle. The number of private equity deals in healthcare has nearly tripled between 2010 and 2019.

Close To Home Corporate takeover is not sparing Fredericksburg though.

The Pratt Medical Center was owned and operated by the doctors in the days when I was there. Now it is in the hands of what seems to be a large, somewhat avaricious company - Hospital Corporation of America (HCA).

Though not a private equity firm, they have a track record that suggests profitability at any cost - in 2012, they paid $1.7 billion (the "largest recovery ever reached by the government in a health care fraud investigation") for what the Justice Department alleged were false claims to Medicare and other federal health programs.

However, The Motley Fool reports now HCA seems to have bounced back, with its stock giving an "almost 900 percent return over the past decade."

A return that benefits the shareholders - though one could fantasize about it being used to reduce prices to patients or improve quality.

It may not be fair to single out HCA, as the corporate takeover of healthcare is just part of a national trend in all sectors that results from "50 years of policies that have prioritized the profit-m making of a few over the wellbeing of many " notes the Mother Jones article.

I see it as a microcosm of the whole wealth inequity that is growing in the US - and that requires strident political lobbying of your politician.

Patrick Neustatter, MD is the Medical Director of the Moss Free Clinic