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Private equity firms acquired more than 500 autism centers in past decade: study
- Krasnol 9mo agoPrivate equity in healthcare shows particularly clearly how far capitalism is willing to go. Profiting from the suffering of humans and animals, while probably still feeling good and even heroic about it, disgusts me.
- mapontosevenths 9mo agoI can see your perspective, but healthcare isn't always a zero sum game. It can be empathetic and useful while also being profitable. It often isn't, but it can be.
- hermanzegerman 9mo agoThere is plenty of evidence that Hospitals, Nursing Homes operated by private equity have way more worse outcomes than those of other operators, even for-profit ones
- accrual 9mo agoYes. It starts benign "no major changes!" and soon stock is reduced, staff get cut, and cost cutting rules are enacted by people who never have to witness the effects on the patients who slip into worse outcomes. And if it crashes into the ground they can float away on golden parachutes.
- Krasnol 9mo agoWhy does it HAVE to be profitable? Why can't we just leave some things out of the whole madness? It's not like we don't have enough stuff that can be made profitable already. Just let your customers be healthy, have a roof over their head, water, electricity, internet. They'll have more time and money to spend on all the other profitable stuff. It doesn't have to be EVERYTHING!
- Panzer04 9mo agoBecause we would like people to continue providing our healthcare services?
- Krasnol 9mo agoWhy should they stop doing that?
- mapontosevenths 9mo agoI dont know about you, but I mostly go to work so they'll pay me money. I then use that money for stuff like food.
- Krasnol 9mo agoIs the money you get from taxes worse then the one you get from private sources or what is it you want to tell me here?
- sergiotapia 9mo agoPrivate equity just makes everything worse for consumer. Squeezes every penny out.
- threethirtytwo 9mo agoMakes sense. Half the people I know now have autism including Elon musk so it’s quite lucrative.
- mapontosevenths 9mo agoThey always did, its just that you now know about it.
- tjwebbnorfolk 9mo agoI know this is the conventional view. But is it possible that the prevalence of autism has been somewhat exaggerated and overdiagnosed? There's a CLEAR profit motive here...
- mapontosevenths 9mo agoYes, but also we've gotten better at diagnosis. Both things are likely true to varying degrees. That said, Elon is one of the most obviously autistic people I've ever seen. He's not a great example of overdiagnosis. In fact, if autism hadn't already been discovered they'd have taken one look at him and invented Elontism.
- threethirtytwo 9mo agoNo it's not over exaggerated at all. Autism is highly prevalent and everywhere. The industry made a mistake, it originally assumed autism was a rare condition, but now we're starting to see that it's a personality trait because it's so common. We're coming to similar realizations for other things like the concept of gender as well as society modernizes and gets rid of out-dated thinking practices.
- mapontosevenths 9mo agoAutism is not a personality trait. Many people are severely disabled by it and are essentially non-functional. Only about 15-20% have full time jobs. The suicide rate is incredibly, almost unbelievably, high. I think it was something like 80% have attempted suicide. Personally I think we need more subtypes again. Its weird to lump high functioning aspergers folks like the richest man in the world into the same category as those who have to wear helmets and be physically prevented from harming themselves.
- JumpCrisscross 9mo agoIf we’re going to stick with private ownership of our healthcare infrastructure, patient-facing providers should at least be required to be B Corps, with one Board seat set to represent the doctors’ and nurses’ interests and a second patients’ interests. (Not sure how you’d elect the latter.) There should also be strict leverage, related-party transaction and dividend limits. In exchange, we might provide a public lender of last resort for healthcare providers who need a lifeline. Banning private equity from healthcare is a good headline. And if I were a candidate, I’d probably run on it. But it’s a band-aid to a broader incentive problem.
- chneu 9mo agoThe issue is, at least in the US, if we ban PE/VC from healthcare, who is going to do it? Americans are deeply divided on the big bad guvmit
- callc 9mo agoI have hope that the newer generations don’t align with “big bad guvmit”, and there’s been enough negative experiences (direct and indirect) with healthcare that people will vote for alternatives. Also, I am saddened by the shared anxiety of healthcare in US (availability while jobless, f*** by big bills, lack of care, etc). The raw amount of shared mental stress must contribute to lower lifespans :(
- wyre 9mo agoMy impression on the newer generation is either socialist or republican with little in between.
- GrowingSideways 9mo agoI suspect many republicans are much more pro-socialism than they realize if you don't use the term socialism.
- SXX 9mo ago
- andy99 9mo agoThese should be useful signals to regulators. Regulation is imperfect but somehow we blame companies that take advantage, either of immature or nonexistent regulation (which might be the case here) or of poorly written regulation (e.g. circa 2000 California energy regulation that let Enron and company run wild). These companies, in finding essentially arbitrage opportunities, are, perversely, helping strengthen regulation, but only if regulators pay attention to what is going on and do something about it, instead of just watching it happen.
- 20after4 9mo agoThis fails to recognize the existence of lobbyists and regulatory capture.
- KPGv2 9mo agoNo it doesn't. Nothing about what you're responding to indicates they're ignoring these things exist. Unless your argument is "lobbyists exist, so we should ban all regulations and go back to the wild west," then the sentence where the person referred to regulation as "imperfect" encompasses lobbying.
- cogman10 9mo agoI really dislike this, especially because it ultimately results in worse care for the kids. I think the place I take my kid to for therapy is likely private equity owned, but it's also about the only place available in my area. I know they are charging around $80 per season, and I also know that the salaries for their therapists are around $25 to $30 per hour. That leaves a very healthy margin for everything from employee benefits to building rental to admin (which I think is probably where the majority of margin goes).
- accrual 9mo agoIt's worth asking if you're curious or have a good relationship with the provider. Some may be willing to tell all about their ownership or management situation if prompted politely. I know of a childcare center that was acquired recently. Not sure if by PE or just another business, but the employees are less than thrilled with the changes.
- didntknowyou 9mo agohaving work in an industry affected by PE buyouts, a lot of these are transactions acted on at management level by businessmen and MBAs/consultants in their offices with no clinician input, yet the hate seems directed at front-line staff.
- Plasmoid 9mo agoI think you're over-estimating how much slack there is in the organization. A rule of thumb is that benefits cost an employer 25-30% of salary. So you're already pushing to 50% of revenue going to direct salary costs. Then there are employees in non-revenue roles (HR, legal, accounting, IT, etc...) and employees doing non-revenue work. Finally, you have rent, licensing, insurance, and all the other fixed costs.
- WalterBright 9mo agoAn awful lot of businesses go under from underestimating what their expenses inevitably will be. Everyone they deal with has their hand out to get paid.
- Buttons840 9mo agoIs it even moral to help people if investors aren't making a profit in the process? (/s)
- InMice 9mo ago> The primary concern is that private equity firms may prioritize financial gains over families, said Daniel Arnold, a senior research scientist at the School of Public Health. ...may? How are they not already by gobbling them up in a calculated way. Targeting states with lax insurance claim scrutiny
- hermanzegerman 9mo agoWe already know that Private Equity kills people in the hospitals [1] and nursing homes [2] for profit. So why do we continue to allow them to operate Healthcare facilities? [1] https://jamanetwork.com/journals/jama/fullarticle/2813379 https://jamanetwork.com/journals/jama/fullarticle/2813379 [2] https://www.nber.org/papers/w28474 https://www.nber.org/papers/w28474
- cogman10 9mo agoBecause we have governments anemic to running anything or regulating any business. They are much more likely to continue shoveling cash into private businesses through subsidies then to want to setup and/or run the same business for a fraction of the cost.
- tjwebbnorfolk 9mo agoThe same one who just said PE isn't allowed to buy any more residential real estate? I hope they go after hospitals next.
- cogman10 9mo ago> The same one who just said PE isn't allowed to buy any more residential real estate? We'll see. That was just an EO. That doesn't really have the force of law behind it. There's not a regulatory body (AFAIK) that would or could prevent PE from gobbling up a home. But if there's a route to stop it then I'm not opposed to it. PE buying essential goods and industries is bad for everyone.
- tootie 9mo agoIt wasn't even an EO. It was a tweet.
- deleted 9mo ago[deleted]
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- analog8374 9mo agoBecause autists make the best engineers? So autism center becomes a recruiting tool.
- class3shock 9mo agoReading the headline all I can think about is that many people with autism are not capable of communicating, or if they are, only in a limited way. Literally people who do not have a voice to speak for themselves.
- bunnybomb2 9mo agoLike severe autism? Yeah. Moderate and below that I think you can live a pretty free life. Its not like down-syndrome. Autism is surprisingly normalized.
- class3shock 9mo agoYes, depending on whose stats you use it's 20-30% of those diagnosed. Not a small amount and people I worry about being dependent on private equity. https://pmc.ncbi.nlm.nih.gov/articles/PMC3869868/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3869868/
- bunnybomb2 9mo agoAh yeah
- renewiltord 9mo agoPrivate equity goes where the money is. Nothing is magically non-exploitative just because it's done by a bunch of small businessmen instead of a private equity company. There's a reason why Private Equity bought so many dialysis clinics. There's a reason why they're doing this. It's easy to scam the government out of money for this because a bunch of well-meaning "useful idiots" will say "pay whatever it takes; give them as much money as they need; it's for human lives!" and none of that is true. It's all about using different battalions to rent-seek on normal tax-paying Americans. Tim Walz lost his hope for re-election over this but he's not the only one. In time we will discover a large array of healthcare scams and home-care and autism/child mental health are going to be near the top.
- hermanzegerman 9mo agoIf your dialysis clinics have the worst outcomes in the industrialised world, it should make you go hmmm. And usually it's not a problem, of "Throwing more money at it", but lack of regulations and enforcing them. That said, Physician Owned Clinics have better outcomes, there is no reason why that shouldn't be the standard model of operating them. Usually they have more moral scruples about worsening care for profit. Also there is naturally more competition, if there are multiple small operators instead of only Fresenius Nephrocare or DaVita https://www.cbsnews.com/texas/news/death-rates-at-u-s-dialysis-clinics-among-the-highest-in-the-industrialized-world/ https://www.cbsnews.com/texas/news/death-rates-at-u-s-dialys...
- renewiltord 9mo agoThe dialysis clinics are bad and make all the money because it’s Medicare fraud dude. Well meaning morons say “whatever people need we should pay for them” not thinking for a second that some unscrupulous fuck is the one getting the money.
- john-h-k 9mo agoCBS say this then don't publish the data! The data [https://www.transonic.com/renal-disease-in-us https://www.transonic.com/renal-disease-in-us] says that kidney transplants for dialysis patients happen LESS frequently in the USA than in Europe, yet the survival rate is very close - 39% USA vs 41% Europe. This implies that dialysis in the USA is very close or _better_ quality than in Europe - as there is a large difference in transplant rates but only a small difference in survival rates. Maybe the above data is wrong, but CBS don't seem to provide any better data
- blibble 9mo agoah yes, another market where the private equity scum have realised that "the market is inefficient" and that the existing businesses aren't "extracting maximum consumer surplus" fortunately the UK doesn't have this problem for people as the state run healthcare system has set the price floor at zero it hasn't stopped the private equity scum completely though, instead they have bought up most of the country's formerly independent vets > From only 10% in 2013, almost 60% of veterinary practices are now owned by large companies they then immediately "optimise the demand curve", doubling/tripling their prices, meaning there are now people that can no longer afford to treat their pets
- 46493168 9mo ago>“Private investors making a little bit of money while expanding access is not a bad thing, per se,” Singh said. “But we need to understand how much of a bad thing this is and how much of a good thing this is. This is a first step in that direction.” Who gets to say what "a little bit of money" is here?
- dizlexic 9mo agoAre you surprised? there's money to be made.
- xvedejas 9mo agoYou are implying people should shut up about it because it's not novel information. I think "are you surprised?" is a very lame and unoriginal response I see everywhere and doesn't even care to engage with the problem. I think HN's rules suggest you should put in more effort than this.
- SkyeCA 9mo agoIf corporations are people than PE firms should be executed like the leaches on society they are. Nothing makes me see red like the fact that basic services are increasingly being captured by these disgusting rats so they can squeeze every last cent out of society possible.
- ineedaj0b 9mo agoYou should share anger for all the taxpayer dollars being stolen and never spent on the 'victims' its supposedly meant to help. Social programs have been funded, show poor results, then seem like dead ends because of fraud. Stealing money put aside to help the less fortunate is far more heinous imo.
- AngryData 9mo agoEven with the losses a lot more is provided per dollar because its done at-cost, and the majority still going to the most desperate. If we wanted to worry about the bigges source of theft though it is wage theft by a large margin over all other forms of threat combined. And the healthcare industry is ripe with labor abuses.
- _DeadFred_ 9mo agoYou mean like Bret Favre the millionaire conservative ex-NFL quarterback's welfare scandal stealing from the poor? https://en.wikipedia.org/wiki/Mississippi_welfare_funds_scandal https://en.wikipedia.org/wiki/Mississippi_welfare_funds_scan... Or do you mean like Republican Senator from Florida Rick Scott who was elected AFTER he was involve in $1.7 billion dollars in Medicaid fraud (largest in history) and whom the Republican party embraces and endorses and has in a position of power today? https://www.justice.gov/archive/opa/pr/2003/June/03_civ_386.htm https://www.justice.gov/archive/opa/pr/2003/June/03_civ_386....
- nkurz 9mo agoYes, like those. "Stealing money put aside to help the less fortunate" is bad and should be stopped, regardless of the political beliefs of whoever is doing it. The right question to ask is "is this fraud", not "which side are the perpetrators on". Can we join together and agree fraud should be stopped rather than protecting people based on which team they are on? It's fine to question whether something is fraud or not, but once it's clear, let's shut it down and punish those responsible.
- locusofself 9mo agoMy daughter is “on the spectrum” and dealing with these therapy places was just a huge waste of time and money. I don’t know if the places we went to were owned by private equity or what but the quality was really bad and this is in a major metropolitan area that is also affluent. The therapist seemed like good hearted people, but they were paid so miserably that there was constant turnover. The billing practices were always shady and complicated and frustrating. Not to mention most of these places have 6 to 12 months waiting list to see anybody in the first place.
- SoftTalker 9mo agoExactly the same experience with long term care for elderly relatives. It's all about getting their money. Care is perfunctory.
- taurath 9mo agoIf everyone wasn’t held basically at economic gunpoint to a level where they are one or two missed paychecks to living in their car, we could advocate for patients and providers to strike outside of the managers offices or in front of a news station. It’s insane how having no financial security creates a world where they can extract with abandon.
- taurath 9mo agoIt’s part and parcel to the mental healthcare system for the last decade or so. There is no place that does better because every single provider is dependent on private health insurance which rarely pays without major and intense hassle.
- ekjhgkejhgk 9mo agoAbsolute cancer.
- pointbob 9mo ago[dead]
- MarkusAllen 9mo agoReleasing an almost-3,000-page expose on private equity this week. It's hard to argue against those who say private equity ruins everything. It's astonishing. And massively depressing. You can download for free when you search the 'net for Founderstowne.
- Imustaskforhelp 9mo agoWait so are you doing the journalistic action? I can't wait for this to drop. Please give me more details if possible. Massive respects to your journalism, I have a lot of questions regarding this tho, namely how long did it take you to build this expose and where are you gonna drop it because I searched net for Founderstowne but I didn't find anything special, are they the VC fund you are gonna expose?
- MarkusAllen 9mo agoCan I post a direct link here... don't want to be accused of spam? I expose just about everyone as a "roman a clef" (a work of "fiction":>). I'm 58 years old. Entrepreneurial builder. Disgusted by VC/PE. Been writing this book since 1987.
- CamelCaseName 9mo agoSure, why not, share your work! Also, the two links in your profile do not work
- MarkusAllen 9mo agoJust updated. Thanks for the heads up.
- MarkusAllen 9mo agoThe direct link is: https://www.Founderstowne.com https://www.Founderstowne.com
- 9mo ago
- Hnrobert42 9mo agoPrivate equity is into this. Into that. The problem is some folks just got too much damn money. They gotta put it somewhere.
- burnt-resistor 9mo agoThat's it. And everything they touch turns to shit to feed their insatiable, sociopathic greed.
- TrackerFF 9mo agoCome to think of it, I don't think I've ever experienced a product or service that took a turn for the better, after the company was acquired by PE. There might have been a time where PE bought up mismanaged companies, and turned them around - but the PE acquisition spree we've seen for the past 10 years or so...it seems exclusively to cause enshitification. And it is happening everywhere. There will always exist some niche PE firms for every sector out there, nothing is safe.
- SoftTalker 9mo agoYes it happens. It doesn't make headlines. And I'm not sure it happens often.
- 3seashells 9mo ago[dead]
- datsci_est_2015 9mo agoServices that PE has ruined in my city by rent-seeking: - Veterinary services - Dental services - Optometry services - Urgent care services I go out of my (sometimes significantly) to go to non-PE owned companies and services, and the experience is so much better it's like experiencing an entirely different quality of life. My 2¢ is that a decent chunk of the "dissolution of the social contract" in the US is due to the way that people are treated when they interact with these soulless entities.
- ekropotin 9mo agoI wish there were some kind of public database that allowed easy lookup of whether a given company is owned by a private equity firm.
- deleted 9mo ago[deleted]
- encrypted_bird 9mo agoI agree! I think this kind of resource would be very useful to a lot of people!
- tartoran 9mo agoI’d happily pay for a tool that lets me opt out of being slowly nickel-and-dimed by entities optimized for short-term yield. This feels like infrastructure: a small amount of collective effort that gives individuals leverage again. Visibility is the lever. And it could be done, it's just more organizing and involvement in local politics. The information already exists, it’s just effectively invisible, and a small translation layer could collapse it into a one-second answer, letting people avoid operators with a predictable extractive playbook, with the only real challenge being the constant, boring maintenance in an environment designed for churn and opacity. Eventually this should revolve around organizing and politics to make a difference.
- MarkusAllen 9mo ago[dead]
- shark_laser 9mo agoWhat did you think was going to happen when you've got guaranteed payments and a growing customer base as people celebrate their "neurodiversity" whilst at the same time demanding subsidies and yelling "ableist" at anyone who criticises them or the system? So politicians pretend to care by throwing more money at their cronies and get away with it because won't someone PLEASE think of the children. And then people pat them on back and vote for them in the next election, and blame "capitalism" while the people they've just voted back in make millions. They even say "We're also dealing with children who are largely insured by Medicaid programs" and yet still people are failing to join the dots...
- foogazi 9mo ago> and yet still people are failing to join the dots Where is this 'join' translated from ?
- packeted 9mo agoIf anyone wants to see how private equity has transformed the veterinary industry check out www.privateequityvet.org/vet-list - over 7000 practices mapped across the US so far. Our dog died at the hands of a recently acquired PE practice :(
- aristofun 9mo agoCan anyone explain me like im 5 - what is the alternative and what’s so special about private equity firms in this context? Like those centers are going to be owned by someone one way or another - what is so special or bad about equity firms vs alternatives? Genuine question. Because I don’t have a clue how this works in US.
- j-bos 9mo agoJust a driveby speculator but my guess is PE dillutes interest in and responsibility for the businesses. Individuals or family holdings are more likely to have concern for their reputations in addition to finances, public companies are more likely to scrutinized offsetting what would be their much lower reputational concerns. But PE is diffuse and often distant enough to eliminate human reputational concerns while being held to far lower stadards than public companies.
- fc417fc802 9mo agoAn individual likely (hopefully) has a moral compass. A family introduces some perverse financial incentives but you also get long term (ie multi generation) planning and reputation concerns. A group of practicing professionals who own the operation will hopefully exhibit some shared pride and professionalism. A co-op or similar arrangement ties the interests directly to the local community. The larger the public company the less overlap there will be with the customer's interests. At least they might worry about reputation and stock price though. Pretty much the only concern PE has is avoiding litigation. Their primary motivation is maximizing value extraction over the short or medium term.
- aristofun 9mo agoIsn’t the government a worst alternative?
- fc417fc802 9mo agoWorse than PE? I very much doubt that but I guess the answer will depend on the voters, how the healthcare ventures themselves are structured, how much open corruption the local culture tolerates, and similar. However AFAIK most government solutions in the west involve public "insurance" as opposed to the direct operation of health care facilities themselves.
- burnt-resistor 9mo agoTry to buy an HVAC or heavy motor capacitor.. guess who owns all of the manufacturers?
- MarkusAllen 9mo ago[dead]
- whydoineedthis 9mo agoThey started slapping my kids hands, forcibly shoving him back in his chair, and grabbing my kids face and torquing his neck. Jon Paul Saunders, a leader in ABA, swore up and down 'this is the best in ABA'. When I looked at the data, my kid had all but stopped screaming/crying with other RBT's, but was more than double the crying/screaming with the rbt's doing the slap, push, face yank teqnique. At this point, my son had done 18 months of ABA and was being used to train new RBT's (high turnover field of course). The prescribed hitting was creating behavioral problems at home, but was being used to justify extensive hours of ABA. I dont think a profit driven model is great for these kids.