Using health services as a source of profits — more generally, the “financialization of health” — is wrong in principle. Health care is not a commodity. Its aim is, or should be, to promote basic well-being, to prevent and treat suffering, and to increase people’s contributions to society. Yet, in the words of economist Rosemary Batt, private equity “turns health care from a social good into a financial asset.” The goal becomes to make money for the private equity firm and its investors.
The editorial wisely calls for an increase in scrutiny and oversight by the Massachusetts Health Policy Commission and the enactment by the Legislature (if not by Congress) of new regulations. But the state needs to take further steps.
It should reduce the opportunity to profiteer by providing comprehensive health care to all through a uniform, transparent, publicly run health insurance system. Moreover, it should decrease, and ideally eliminate, the ownership of health delivery by private, for-profit entities, including private equity, and instead make health providers responsible to the communities and people they serve.
These actions would return health care to its fundamental mission of helping people and society.
Dr. Paul Sorum
The writer is a professor emeritus of internal medicine and pediatrics at Albany Medical College in Albany, N.Y., and a member of Physicians for a National Health Program.
I was shocked to learn about the role of private equity in the protracted crisis of wheelchair replacement and repair. Numotion and National Seating and Mobility provide unique and necessary services but often only after extreme hassle and extensive advocacy by wheelchair users and their communities.
I have seen my friend, a wheelchair user, spend hours of his day on the phone going back and forth with Numotion, only to eventually have Numotion provide a part or make a repair that is insufficient or even dangerous.
The logic of the private sector simply doesn’t work when it comes to durable medical equipment. Our community doesn’t need more profit for the stockholders to whom private equity is beholden. Our community needs a network of well-trained, well-compensated wheelchair repair people who are ready and willing to provide high-quality service to the community on which their entire business model is premised.
The measure passed this month in the state Senate is an important response to this crisis. It contains common-sense measures that create accountability for these companies and greater certainty for customers.
In 2014 I suffered a catastrophic spinal cord injury after which I was no longer able to walk unaided. The VA Medical Center in West Roxbury gave me a wheelchair. Since then, my repairs have been done by its prosthetics department quickly and efficiently. No waiting.
Your editorial mentioned a bill passed by the state Senate this month that “would require companies to diagnose problems within days and provide a loaner chair while repairs are ongoing.” The prosthetics department at the West Roxbury VA doesn’t need such a bill. It’s what that department does.
Isn’t the solution to problems raised by private equity’s involvement in health care plain to see?
Samuel Jay Keyser
The editorial “Scrutinize private equity’s involvement in health care” astutely calls attention to myriad problems arising from the acquisition of health care entities by private equity investors.
Most notably, the editorial rightfully decries higher costs and poorer patient outcomes among hospitals and practices under the ownership of a private equity group.
Private equity-backed health care facilities should be obligated to be transparent with patients, who deserve to know who owns the practice at which they are seeking care. Importantly, the expectation must be clear that facilities that are privately held be committed to putting patients first — not profits, which are often increased through cutting staff and resources, thus imperiling patient safety. We must ensure that access to equitable, affordable, quality care remains unfettered.
Finally, we must continue to find ways to address issues that lead to burnout and occupational discontent among physicians and their health care teams as well as the economic challenges of running a practice that so often compel physicians to consider selling to private equity firms as a last and best resort.
Dr. Barbara Spivak
Massachusetts Medical Society
The writer is also a primary care physician and president of the Mount Auburn Cambridge Independent Practice Association.
Private equity is like a fungus. It gets a start slowly in dark, hidden places and then bursts all over, contaminating everything, and it is very difficult to eradicate. The best antiseptics are transparency and accountability.
While financial resources are necessary to provide quality health care, profits should not take precedence over patients.
The Legislature must enact comprehensive measures this session.
Paul J. Lanzikos
Dignity Alliance Massachusetts
When a private equity firm — Cerberus (the hound of hell in Greek mythology) Capital Management — bought Caritas Christi Health System in 2010, I could never get an answer to the question: Why? How exactly will they make money on the deal? It turned out Cerberus knew exactly what it was doing when it transferred its controlling interest in Steward Health Care to a group of physicians in 2020.
The easy question of the day: Is Steward too big to fail? Of course it is.
Dr. Owen Reynolds