Abortion Update and Private Equity Issues

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Dec 13, 2023

Good Day Advocates

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Abortion - Legal Observations

There are brave women fighting against the so called exceptions to the abortion laws. I want to be clear - in so many states it is a felony for a medical practitioner to perform an abortion if it is not a medical emergency. Unfortunately, legislators are not doctors and have no idea what an emergency looks like or how a woman’s health might possibly be endangered. High risk complications occur in 6% to 8% of all pregnancies.

Lets not forget that in Texas a brave mom of 2 whose life and health were endangered by a genetic malformation in the fetus had to go to the Texas Supreme Court to get a decision. That means if you want an abortion exception you need money and more importantly time to wait for NON DOCTORS to decide your fate.

Action

Let;s call our Congressperson and Senators (contact info in the Resources Section below) and let them know, over and over, that an abortion exception for the life of the mother is no exception at all if you have to have the time and the money to go to court and get it approved. They need to pass the Women;s Health Protection Act NOW to restore a woman’s autonomy and self determination.

Or use RESISTBOT to send them the email below. Text SIGN PMRSVJ to 50409.

“I am your constituent and I want you to know that in the 24 states that ban abortion there may be an exception in case of emergency. The problem is that there is no clear legal definition of emergency and in many states (like Texas or Kentucky) you have to have the money and time to go to court to get approval so your doctor won’t go to jail. This is a SHAM. If the doctor says it as emergency then it is, NON DOCTORS ARE NOT IN A POSITION TO DEFINE IT. I am so angry about this complete disregard for the lives of women in almost half the country.

YOU CAN FIX THIS - PASS THE WOMEN’S HEALTH PROTECTION ACT. You are either a woman or related to one, their lives are at risk and I expect you to act like this is an emergency. Thank you.”

Private Equity Revisited

I received a note from a healthcare advocate who testified in her state about private equity’s impact on healthcare. Way to go!!.

Here is a good Commonwealth Fund article on the subject - and here is one of my articles on the subject. Here is the reference article and video I used for my previous story. Let’s recall:

First, remember that the goal of this kind of investment is to earn significantly more than a nominal investment in as short a time as possible. Here is the plan we documented:

Create a vertically integrated tower of companies that represent the hospital, it's functions and staff. That means there is one company that owns the land and building, another company responsible for janitorial services, a company responsible for the ER, one for Labor and Delivery, etc.

Try to make each of them profitable. For instance, there may have been no rent on the building before, there is now. Streamline each department for profitability. That means scaling back unprofitable services, reducing staff and supplies. Increase sales of services that are very profitable. For example cardiac services pay a lot, labor and delivery not so much. Outsource functions to save money. Pay huge dividends to the investors as fast ass possible.

Anyway, by the time our example hospital was done, you guessed it, the hospital was bankrupt. It really didn't matter because the profits had already been squeezed out.

Senate Investigation

On December 7, 2023, the Senate Budget Committee launched a bipartisan investigation into the reality of private equity ownership of hospitals in the United States. This investigation stems from concerns around negative patient outcomes associated with hospitals under private equity ownership, and key committee members have sent letters to the CEOs of major private equity firms outlining the Committee’s concerns about how these entities own and operate hospitals.

The Committee’s investigation is the latest signpost of the government’s growing scrutiny of private equity in health care. The Biden Administration has raised concerns about private equity investments in health care, and a series of False Claims Act enforcement actions have targeted private equity firms in the health care sector. Moreover, the Centers for Medicare & Medicaid Services (CMS), with its current focus on private equity in the long-term care sector, has publicly criticized private equity owned and operated entities, and increased provider enrollment requirements to require full disclosure of private equity ownership (and control). CMS has also indicated that concerns with private equity operations were part of the reason for its revised requirements for increased scrutiny for Medicare participation approvals for nursing facilities.

How Much of A Problem Is It?

The health care industry has experienced a surge in private equity investment in recent years, culminating in a record-breaking 515 deals valued at $151 billion in 2021. At least 386 hospitals are owned by private equity firms in the United States. Notably, these hospitals are largely owned by a handful of private equity firms with a keen focus on rural populations, accounting for over a third of for-profit hospitals.

Senate Budget Committee Concerns

The Senate Budget Committee’s press release associates private equity ownership of hospitals with:

Significant staffing reductions
Substandard health care
A stripping of valuable assets (including real estate)
Unmanageable leveraged debt
Facility closures
The prioritization of profits over patients

Senate Budget Committee Chairman Sheldon Whitehouse elaborated on what he said was a common practice observed in hospitals under private equity ownership. In this routine, private equity firms acquire a hospital, amplify its debt while implementing substantial cost-cutting measures, and subsequently divest the hospital. The Committee’s concern is that this practice frequently leaves the hospital in a precarious state, devoid of essential operating resources, and functioning with minimal staff. Significantly, nearly 90% of health care companies classified as financially distressed by a leading credit agency are under the ownership of private equity firms.

This was just reported in the National Law Review on 12/12/23. Here is the link. I called the Senate Budget Committee and asked if they had anything to release yet. The answer was not yet, but they told me that the results of the investigation will be posted by the Chairman, Senator Whitehouse, on their web page. Watch this space.

P.S. My family experienced this kind of behavior first hand at Hollywood Presbyterian Hospital. It was a very bitter experience to see outsourcing of critical functions and draining of resources, leaving a pale shadow of a once outstanding facility.

RESOURCES

Healthcare Advocacy (Us)

Website

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Find My Elected Officials

Contact the White House https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

Important Healthcare Resources

League of Women Voters Healthcare Reform Toolkit

Organizations to Contact

National Nurses United Medicare4All

Physicians for a National Health Program

One Payer States

Healthcare Now

Reproductive Health

NARAL - Pro Choice America

Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion

Planned Parenthood

Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.

United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.

Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.