March, 22 2023, 01:16pm EDT
Action on Predatory Private Equity in Health Care ‘Needed, Stat’ Says Public Citizen
New Report Outlines Private Equity’s Toll from Nursing Homes to Reproductive Health
A new Public Citizen report released today examines private equity’s toll on U.S. health care in more than a dozen sectors, from end-of-life care and home health care to dentistry and reproductive health. Increased private equity takeovers have come with shocking lapses in safety, with prices rising faster than at non-private equity acquired entities, while patients have been subjected to price gouging schemes.
In the report, Public Citizen calls for action from Congress and the Biden administration to increase oversight and accountability for private equity firms in health care.
Private equity acquisitions in the health care sector have steadily climbed since the financial crisis in 2009, particularly in the past five years. Unlike acquisitions of hospitals, which typically occur under a public spotlight, the private equity industry’s acquisitions of physician practices and other health care business lines often occur with little or no disclosure or public scrutiny, hindering the ability of regulators and watchdogs to monitor the effects of private equity ownership.
“Thanks to a lack of transparency, we don’t know everything about private equities’ incursion into health care. But what we do know is shocking and immoral,” says Eagan Kemp, health care policy advocate at Public Citizen. “The damage that private equity has wrought on Americans’ health care from cradle to grave, simply for profit, has become a life or death situation. Transparency and oversight are needed, stat.”
The report compiles findings from various health care sectors, including:
- End-of-life care: Researchers have found that over 70 percent of the hospice agencies acquired between 2011 and 2019 were previously nonprofit.
- Home health care: Private Equity Stakeholder Project (PESP) reported that nearly half of all home health care deals in 2018 and 2019 involved private equity. Initial data for 2020 indicated even more investment by private equity firms into home health care companies. PESP noted that several companies came under increased scrutiny on issues of patient safety, inadequate staffing, and failures that required investigation by state regulators.
- Traveling nurses: While private equity firms were already investing in traveling nurses prior to the COVID-19 crisis, recent years have seen record numbers of acquisitions.
- Nursing homes: One study, which reviewed data from 2005 to 2017, found that residents of private equity-owned facilities were 10 percent more likely to die when compared with any other type of facility.
- Reproductive health: Private equity companies have bought up three of the four major staffing companies for obstetrics emergency departments, emulating some of the profitable tactics they used in other sectors but in a gray area around the standards for defining live births as emergencies. They have been accused of classifying even normal births as emergencies, allowing them to charge patients additional fees.
- Gastroenterology: One analysis found that from 2020 to 2021, acquisition of gastroenterology practices grew by nearly 30 percent. Another found that as of fall 2021, nearly 10 percent of the 14,000 gastroenterologists worked in practices that were either owned or backed by private equity.
There are also additional steps the federal government can take to better ensure that health reporting requirements improve transparency and accountability. The Biden administration has already begun to implement additional requirements that would improve transparency of ownership, including publishing the ownership information of thousands of hospitals. Similar efforts in other areas of health care would be a positive step in the direction of oversight and accountability for private equity firms in health care.
In addition, Rep. Pramila Jayapal is expecting to reintroduce the Healthcare Ownership Transparency Act, which will require private equity firms and other financial interests to disclose ownership stakes in health care facilities including nursing homes.
“We applaud Rep. Jayapal’s ongoing effort to shine a light on the dangerous toll private equity vultures are taking on our health,” says Robert Weissman, president of Public Citizen. “Adequate regulation of this predatory industry is acutely critical when it comes to the health care sector.”
Public Citizen is a nonprofit consumer advocacy organization that champions the public interest in the halls of power. We defend democracy, resist corporate power and work to ensure that government works for the people - not for big corporations. Founded in 1971, we now have 500,000 members and supporters throughout the country.
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Ignore the Cosplay. Trump's Record Shows He 'Does Not Give a Damn About Working-Class People'
"Donald Trump left workers behind when he was president," said United Auto Workers president Shawn Fain.
Nov 04, 2024
The final stretch of the 2024 U.S. presidential race has seen Donald Trump, the billionaire Republican nominee, perform a staged shift at a Pennsylvania McDonald's and dress as a garbage truck driver in a clear effort to appeal to working-class voters who are set to play a decisive role in Tuesday's election.
But a detailed examination of Trump's first four-year term in the White House shows that despite his recent cosplaying, the GOP nominee was no ally of the working class when he was in a position to influence and enact policy.
"When Donald Trump was president, he repeatedly tried to raise the rent on at least 4 million of the poorest people in this country, many of them elderly or disabled," the investigative outlet ProPublicareported over the weekend. "He proposed to cut the federal disability benefits of a quarter-million low-income children, on the grounds that someone else in their family was already receiving benefits. He attempted to put in place a requirement that poor parents cooperate with child support enforcement, including by having single mothers disclose their sexual histories, before they and their children could receive food assistance."
Additionally, the outlet noted, Trump "tried to enact a rule allowing employers to pocket workers' tips" and succeeded in enacting "a rule denying overtime pay to millions of low-wage workers if they made more than $35,568 a year"—all of which casts serious doubt on the Republican candidate's pledge to prioritize the economic interests of U.S. workers in a second term.
ProPublica also analyzed Trump's proposed federal budgets from 2018 to 2021 and found that the former president "advanced an agenda across his administration that was designed to cut healthcare, food, and housing programs and labor protections for poor and working-class Americans."
Meanwhile, Trump worked with his Republican allies in Congress to ram through a massive tax cut for the rich and large corporations—a measure he wants to double down on if he defeats Democratic nominee Kamala Harris on Tuesday.
Trump's 2024 campaign has featured some policy proposals aimed at boosting the working class, such as eliminating taxes on tips and overtime pay.
But economists and progressive organizers have argued that the benefits of such policy changes would be marginal compared to broader proposals that Trump has not backed, such as raising the federal minimum wage and eliminating subminimum wages for tipped workers. A recent Institute on Taxation and Economic Policy analysis found that Trump's economic plans overall would cut taxes for the richest 5% of U.S. households while raising them for the bottom 95%.
During his McDonald's stunt last month, Trump ignored a question about whether he supports raising the federal minimum wage, which has been stuck at $7.25 an hour for over 15 years. Harris, by contrast, has expressed support for lifting the federal wage floor to at least $15 an hour.
"He does not give a damn about working-class people," United Auto Workers president Shawn Fain said of Trump during an appearance on MSNBC alongside Rep. Alexandria Ocasio-Cortez (D-N.Y.) late last week. "Donald Trump left workers behind when he was president. He did nothing to stop manufacturing plants leaving this country."
"With the Harris and Biden administration, we have seen a bigger investment in this country and manufacturing than I have ever seen in my lifetime. They walk the walk," Fain added. "Trump is all talk."
In a video message to the country ahead of Election Day, Sen. Bernie Sanders (I-Vt.) similarly criticized Trump as an opponent of union rights and argued Harris is the "clear" choice for those who want to improve the lives of working-class Americans.
"While some of us may have differences of opinion and disagree with Kamala Harris on this or that issue, I hope very much we will not sit out this election. We cannot sit it out," said Sanders. "So let's get involved. Let's do everything we can. Let's come out and vote on Election Day, and let's make sure that Donald Trump is defeated and that Kamala Harris is our next president."
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'The Big Lie Is Back' as Trump's GOP Reboots Felony-Facing Fake Electors
"The election deniers are back at it, laying the groundwork to run the Big Lie playbook once again," warned one swing-state campaigner.
Nov 04, 2024
At least 1 in 5 potential battleground state electors for former U.S. President Donald Trump are linked to the Republican nominee's attempt to subvert the 2020 election, according to an analysis published Monday.
Politico reported that "of the 93 Republicans designated as prospective presidential electors for Trump from the seven battleground states, eight are facing felony charges for signing false Electoral College certificates in 2020."
Five additional possible electors signed similar documents in 2020 but were not criminally charged, according to the reporting, while at least half a dozen others "played notable roles in challenging the results of the 2020 election or promoting election conspiracy theories."
"These people continued to peddle and push not misinformation, which is accidental, but disinformation, which is intentional."
With numerous Trump aides and GOP officials facing criminal charges for their alleged roles in the former president's bogus "Stop the Steal" scheme, experts say it is somewhat less likely that the Republican nominee or his allies would attempt another such plot. However, Trump and his boosters have recycled similar claims of election fraud in what critics say is a bid to spread misinformation and sow doubt about the outcome of Tuesday's contest if the 2020 loser is defeated by Democratic Vice President Kamala Harris.
"It does show a lack of regard for the criminal and ethical problems with doing this," Mary McCord, a Georgetown law professor and executive director of the Institute for Constitutional Advocacy and Protection, told Politico.
As Politico notes:
Six of the returning fake electors hail from Michigan. John Haggard, Hank Choate, Timothy King, Meshawn Maddock, Amy Facchinello, and Marian Sheridan were among the group of Michiganders who signed a document in 2020 purporting to be official electoral certificates claiming the state’s electoral votes went to Donald Trump, despite Biden winning Michigan by more than 150,000 votes. Michigan Attorney General Dana Nessel, a Democrat, brought felony charges against them, including forgery-related crimes punishable by up to 14 years. Those cases are ongoing and all have pleaded not guilty.
In the battleground state of Wisconsin—where President Joe Biden defeated Trump by less than 21,000 votes, or 0.63%, in 2020—"election deniers are back at it, laying the groundwork to run the Big Lie playbook once again through actions designed to attack the electoral process, sow seeds of chaos set to bloom post-election, and further undermine confidence in our democracy," warned Wisconsin Democracy Campaign executive director Nick Ramos in a Sunday opinion piece in the Cap Times.
"That is exactly what their antics wrought after the 2020 election—chaos resulting in the January 6 insurrection and years of baseless conspiracy theories that did not, and will not, succeed in changing a single election result but did succeed in undermining the confidence of millions of Americans in our democracy," he continued.
"The bullies are back again, continuing their strategy to interfere in Wisconsin's elections," Ramos added.
While some observers claim that would-be election subversives are likely to tread gingerly in light of the potential criminal consequences for alleged Big Lie conspirators, McCord said that "it would appear that the party leadership in the states where there are fraudulent electors serving as electors again are not taking seriously things like the criminal charges that have been brought against these fraudulent electors."
Amy Tarkanian, a former chair of the Nevada Republican Party, told Politico that "these people continued to peddle and push not misinformation, which is accidental, but disinformation, which is intentional."
"It's definitely disappointing," she lamented.
In Arizona—where former state GOP chief Kelli Ward and 11 other Republican officials have been criminally charged in connection with the alleged fake electors scheme—current Republican Party Chair Gina Swoboda has been pushing spurious election fraud claims. This, even as Loraine Pellegrino, a past president of a right-wing women's group who falsely attested that Trump won Arizona in 2020, earlier this year became the first person convicted in the state's fake electors case.
Democracy defenders have sounded the alarm on the potential for violence fueled by baseless claims of election fraud.
The Global Project Against Hate and Extremism said last week that it is "seeing the same warning signs of political violence based on election denialism combined with violent language across fringe platforms that we saw in the weeks before the 2020 election and before the January 6, 2021 insurrection at the Capitol."
According to a YouGov poll published Saturday, just over two-thirds of respondents—including more than 80% of surveyed Democrats and 55% of Republicans— believe it is either "somewhat" or "very likely" that Trump will refuse to concede if he loses to Harris.
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New Reporting Details 'Large Scale' Use of Human Shields by Israel in Gaza
"The earliest testimony we have on it is from a soldier who was aware of it just a few weeks after the ground invasion began," one human rights expert said. "The latest testimony we have on this is from the summer."
Nov 04, 2024
The Israel Defense Forces routinely use detained Palestinians as human shields in Gaza, according to testimony from four Palestinians and one IDF soldier shared withThe Washington Post.
Their stories, published on Sunday, build on other accounts from Haaretz, Al Jazeera, the international press, and Defense for Children International to reveal a pattern of Israeli soldiers forcing Palestinians—including children—to enter buildings or tunnels ahead of them to check for militants or explosives, in clear violation of international law.
"This wasn't something that happened just here and there but rather on a large scale throughout a number of different units, at different times, throughout the war and in different places," Joel Carmel, advocacy director of Breaking the Silence, told The Washington Post.
"My hospital was turning into rubble, and they were asking me to demolish it with my own hands."
The incidents recounted to the Post occurred between January and August. One man, 20-year-old Mohammed Saad, said he was detained by the IDF in June and interrogated for several days. Then, a new pattern began. Every day, he and two other Palestinian men were blindfolded and taken to a different location. They were made to wear IDF uniforms, given cameras, and told to enter buildings ahead of the Israeli soldiers to film and check for explosives. On the second day, an explosion went off after Saad had made his forced investigation.
"They tied my hands and threw me on the sand," he recalled. "They took turns beating me. I still don't know where the explosion came from."
Another time, the captain of the unit he was detained by showed him an image of his family home destroyed by bombing.
"If you do not cooperate with us, we will kill all your family members like this," the captain said.
On the 15th day of Saab's ordeal, he was given civilian clothes and told to walk. As he did so, he felt a pain and realized he had been shot in the back.
The other three Palestinians interviewed by the Post were detained during the IDF's raid on al-Shifa hospital in Gaza City in March. One was a surgeon at the hospital, while the other two were taken from their homes nearby. They were made to enter the hospital building ahead of IDF troops, remove any barriers, and take pictures of each room they entered.
"I was telling them that my hands are precious for my work; I am the only vascular surgeon here," the surgeon, Omar al-Jadba recalled to the Post. "My hospital was turning into rubble, and they were asking me to demolish it with my own hands."
The IDF soldier, who spoke anonymously, said that two Palestinian detainees were placed with his unit to make sure that buildings were safe to enter. One of them was only a teenager. His commander said the two men were terrorists, but then later said they could be released after the mission was over.
"At this point we understood that if we could release them, then they were not terrorists," the soldier, a reservist, told the Post. "The officer just lied to us."
"Every one of their accusations is a confession."
Another group of soldiers questioned the use of human shields, telling a higher-level commander that it was against international law.
"He told us that international law is not important and the only thing that simple soldiers need to think about is the ethical code of the IDF," the soldier told the Post.
However, the IDF said in a statement that its orders prohibit the use of human shields.
Breaking the Silence, a group that records testimonies from Israeli soldiers in the occupied Palestinian territories, said the reservist's account was in line with others they had received.
"The earliest testimony we have on it is from a soldier who was aware of it just a few weeks after the ground invasion began," Carmel said. "The latest testimony we have on this is from the summer."
The
Post reporting came the same day as a major Associated Press investigation into Israeli raids on three hospitals in northern Gaza at the end of 2023. Israel has often justified its hospital raids with the claim that Hamas operates from the inside, turning all the patients and doctors into human shields. However, the AP concluded that
"Israel has presented little or even no evidence of a significant Hamas presence at the three" hospitals it considered: the al-Awda, Indonesian, and Kamal Adwan hospitals.
"What do [former U.S. President Donald] Trump and [Israeli Prime Minister Benjamin] Netanyahu have in common?" asked journalist Mehdi Hasan in response to the Post's reporting. "Many things but especially... projection. Every one of their accusations is a confession."
Other commenters responded to the clear violations of international law and questioned why the U.S. continues to provide weapons and funding to the IDF while it engages in war crimes.
The Austin for Palestine coalition shared a quote from the article, noting that what it described was "paid for by our tax dollars."
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