Welcome to You’re Probably Getting Screwed, a weekly newsletter and video series from J.D. Scholten and Justin Stofferahn about the Second Gilded Age and the ways economic concentration is putting politics and profits over working people.
When Private Equity gets involved in your healthcare… You’re Probably Getting Screwed. I’m J.D. Scholten and this week we are raising awareness of the impact PE has at the doctor offices.
So far, PE has penetrated mostly in emergency medicine, anesthesiology and radiology but they’re constantly looking to grow.
For patients, this often leads to higher costs and less care.
For physicians and staff, it leads to staffing shortages, burn out and higher rates of turnover.
An example of how complicated the issue can be is if you’re seeing an orthopedic doctor, the front desk might be employed by PE and your doctor is a different entity.
Policymakers are starting to wake up. At the state level, there’s a bill that just passed out of the Oregon House that looks to close loopholes and strengthen the laws on the books against the corporate practice of medicine.
Federally, there are 4 transparency bills with the best one being Representative Jayapal’s HOT Act.
And Tuesday the FTC will be hosting a virtual workshop on this issue.
People are waking up to this problem. Until something is done, you’re probably getting screwed.
YOU’RE PROBABLY (ALSO) GETTING SCREWED BY:
Kroger-Albertsons
Kroger and Albertsons want to create a grocery giant that would raise prices (even further) and harm workers. The $25 billion mega-merger has attracted state antitrust scrutiny but this week the Federal Trade Commission and a bipartisan group of 9 state attorneys general filed to block the merger. One of the more interesting aspects of the FTC challenge is its focus on protecting collective bargaining rights for grocery workers.
Anesthesiologists
A national private-equity owned anesthesiology practice called U.S. Anesthesia Partners has used exclusive contracts with hospitals to raise costs for patients being sedated during surgery. But Colorado Attorney General Phil Weiser announced a settlement busting up that monopoly this week!
Healthcare Monopolies
UnitedHealth Group is a sprawling healthcare giant that is not only the country’s largest insurance company (which is using AI to deny elderly patients coverage), but owns one of the big three PBMs (Optum Rx), as well as owning and managing medical groups. Good news this week is that the Department of Justice has reportedly launched an antitrust investigation into the company’s practices.
Rental Prices
Rent is unaffordable for half of Americans and part of the issue might be a real estate management firm RealPage, whose pricing algorithm allows landlords to price-fix rents. Fortunately, this week Arizona Attorney General Kris Mayes sued RealPage for creating a rental monopoly that is illegally price-fixing rents.
Pharmacy Benefit Managers
Speaking of algorithmic price-fixing, since January four major PBMs - Express Scripts, Caremark, MedImpact and Navitus Health - have started using digital health platform GoodRx. According to experts and pharmacists in a story by The Capitol Forum, GoodRx has enabled PBMs to coordinate and drive reimbursement rates for independent pharmacies even lower.
Corporate Tax Evasion
Remember the Trump Tax Cuts? The ones that made life better for folks…if they are a giant corporation!? A new study from the Institute on Taxation and Economic Policy found that companies like T-Mobile, DISH Network, Netflix, General Motors, AT&T, Bank of America, Citigroup, FedEx, Molson Coors and Nike (among many others) paid an effective tax rate of five percent or lower since passage of those corporate tax cuts.
SEC Disclosure Rules
Stacy Mitchell, Co-Director at the Institute for Local Self Reliance, has a fantastic piece in The Atlantic about how Amazon has potentially exploited weak disclosure requirements from the Securities and Exchange Commision to hide profits that would make its monopoly power more evident to journalists and regulators.
Some good news from the Midwest
Justin and I had exciting weeks in our respective states and we wanted to highlight that work:
My colleagues in the Iowa Legislature passed a new bipartisan law prohibiting foreign entities from gobbling up farmland, a first step in strengthening limitations on corporate ownership of farmland in Iowa.
In Minnesota a group of legislators and Attorney General Ellison unveiled the “Unrigging Minnesota’s Economy” agenda, a package of bills that would end junk fees, give farmers the right to repair, prohibit medical debt, and modernize the state’s antitrust law.
BEFORE YOU GO
Before you go, I need two things from you: 1) if you like something, please share it on social media or the next time you have coffee with a friend. 2) Ideas, if you have any ideas for future newsletter content please comment below. Thank you.
Standing Tall for All,
J.D. Scholten
Tax at 100% all wealth over about 10 or 15 million dollars. There should be no billionaires or mere hundredmillionaires. This should be done globally in every country on earth. As for here in the usa, retroactively repeal the Reagan, Clinton, Bush and Trump tax cuts for the rich and corporations. Restore Glass-Steagall. Restore the tax rates on the rich from the 1950’s. Restore the inheritance tax which only hits the rich. Restore the tax on stock transactions. Remove restrictions from the unions and repeal the Taft-Hartley act. Repeal “citizens united”. Enact and install universal healthcare. Place the corporations, the banks and wall street on short leashes. Restore the FCC fairness doctrine.
Speaking of out-of-control medical expenses, I was informed that "Go Fund Me' is now owned by a private equity company!!!! who plan on getting their share of profits from those who are forced to beg friends & strangers for money to help cover medical expenses NOT covered by their "health" insurance!