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If you are interested in following Layoffs around the country, this site lists them daily:

DAILY JOB CUTS

The HOSTESS layoffs prompted a check to see what else is going on in Layoff Land.

Today, there are 6 hospitals announcing layoffs.  Hospitals?  Layoffs?  What's with that.

Well, lo and behold, Private Equity Firms like Ceberus are investing in hospitals.  This won't end well if the Working Model for Private Equity firm investments remains the same.  Matt Taibbi does a great job explaining exactly how they work:

Greed and Debt: The True Story of Mitt Romney and Bain Capital

In short, Private Equity firms put up a small amount of money, borrow a large amount of money, buy an entity, pay the entity's Executives VERY well, and look for ways to "trim the fat" to make the entity more profitable which often fails because of the huge debt the entity is forced to take on, which is used to pay huge Salaries/Bennies to the entities upper management and consulting fees to the Private Equity firm.  It's an easy set up for layoffs, wage reductions, cut backs in hours, short cuts, and ultimately bankruptcy and lost pensions, all of which Matt explains perfectly.

Are hospitals, which people depend on to SAVE THEIR LIVES, an appropriate venue for Private Equity firms?  The casual observer would most likely say no, however, no one on the State levels are objecting.

Imagine my surprise when I looked into the first hospital layoff to find that former VP Dan Quayle's Ceberus owns it.

Layoffs loom at Carney Hospital

Carney Hospital is part of the Steward Health Care System, which includes Quincy Medical Center, Merrimack Valley Hospital and Norwood Hospital. Steward, affiliated with Cerberus Capital Management in New York, acquired Carney in 2010 as part of its purchase of the Caritas Christi Health Care hospitals.
A little more digging and the following helps explain this disturbing trend.

Becker's Hospital Review is an information service that helps those interested in the Hospital industry, also called Ambulatory Surgery Centers (ASC)

Becker's published this

How Private Equity Views ASC Investment

Mr. Shah said there is currently private equity activity in the ASC space, explaining that the industry has "lots of potential opportunity given how fragmented the industry is."

According to Mr. Cockrell, private equity investors are looking for "a platform [they] can really scale," noting that not every industry is accommodating to that type of growth. For the ASC industry, its fragmentation does provide a significant opportunity for scale.

In addition to scalability and growth, private equity funds also make investment decisions based on the finances of the company they may invest in. For example, very large private equity funds are not usually interested in deals below a certain EBITD* because they focus on a smaller volume of high value deals. Middle-market funds, as their name suggests, are more likely to be interested in companies with a bit lower EBITDA. The panelists noted that most middle market funds are looking for companies with somewhere around $10 million in EBITDA.

Mr. Becker noted that in addition to private equity funds, venture capital funds are also potential investors in surgery center companies. In general, private equity funds look for more mature, stable groups to invest in, while venture capital funds are willing to take on a bit riskier investment.

Mr. Shah said that private equity activity in general is currently quite strong, and he hasn't seen this level of private equity investment since 2006-07. He expects private equity to continue to be quite active in the near future due to its more recent acceptance as a core asset class for institutional investors, such as pension funds.

*EBITDA MEANS:  Earnings Before Interest, Taxes, Depreciation and Amortization

It is ironic that the growth in Private Equity investments comes from pension funds, imo.

Becker's also published this list of 19 Recent Hospital Mergers & Acquisitions on September 4, 2012.

There are trends revealed by reading the Daily Job Cuts and Beckers material.

1.  Hospitals moving to becoming just outpatient care.
2.  Merging with other hospitals
3.  Affiliating with other hospitals
4.  Acquisitions of hospitals
5.  Private Equity firms and Venture Capital firms are interested in investing in hospitals.

I suspect the mergers, partnerships, and affiliations are a first step to creating a large enough entity to qualify for a buy out.  You see, upper level management of these hospitals get paid off in the deal.

Hostess Blames Union For Bankruptcy After Tripling CEO’s Pay

A trend of rising CEO pay in times of economic difficulty. At the manufacturing company Caterpillar, for example, they froze workers’ pay while boosting their CEO’s pay to $17 million. And at Citigroup, CEO Vikram Pandit received $6.7 million for crashing his company, walking off with $260 million after the business lost 88 percent of its value.
This was written by "puzzled" in the following comment stream:
The much touted "free market" just doesn't work where hospitals are concerned.  People don't choose whether or not to have an appendectomy this week, or shop around for the lowest cost trauma surgeon when they're in the back of an ambulance.

I'll leave further analysis to the experts; however, these trends raise more than one alarm for me.

Public hospitals are becoming privatized which, in my opinion, puts the public at risk as the new owners number one job is to protect investors/investments.

Like other markets, there is a very good risk that we will end up with Hospital Chains, just like laboratories have become national chains.  National chains are bottom line driven, low wage paying, fat trimming by nature and design.

So I ask:

Will the medical needs of the people of this country be well-served if these trends continue?

Your thoughts?

Gordon Gekko seems to have millions of clones out there!

Poll

The US privatized health care industry is putting lives at risk

96%120 votes
4%5 votes

| 125 votes | Vote | Results

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Comment Preferences

  •  Wow. You complied an excellent report here. (23+ / 0-)

    Recommended.

    For profit hospitals and insurance companies are now excellent investments. They're backed by the government. Like defense contractors, they are solid gold.

    I'm not an equities investor, however.


    A child of five would understand this. Send someone to fetch a child of five. -- Groucho Marx

    by Pluto on Fri Nov 16, 2012 at 06:12:13 PM PST

  •  They Have to Bust Things Up Now, There's Not (19+ / 0-)

    enough spending power left in the masses for capital to invest in production growth.  All they can do now to gain returns is swing the wrecking ball.

    My guess is that health care for the masses will move to a dental insurance model: preventative care, and modest discounts for fortune-busting major procedures.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Fri Nov 16, 2012 at 06:13:18 PM PST

  •  This will be a disaster. nt (16+ / 0-)

    "I was a big supporter of waterboarding" - Dick Cheney 2/14/10

    by Bob Love on Fri Nov 16, 2012 at 06:15:05 PM PST

  •  Speculators Can Not Be Allowed To Own Vital Public (17+ / 0-)

    infrastructure - utilities (incl. airlines and phones), roads, hospitals (all of which were not-for-profit or public until the Reagan Reversion), food sources, drug companies, etc.  

    A big part of the high quality of life that Americans used to have was a direct result of our highly regulated infrastructure.  Did Enron make no impression on our legislators?

    I hope your diary is seen by many, many people.  And I'd like to send a copy to my senator, Sen. Durbin's office, if you don't mind.

  •  holy crap! this is unreal (8+ / 0-)

    i mean, i long ago decided that hospitals were the next frontier in for-profit health care, that that's where the industry money would go now that health insurers are facing the exchanges.  but vulture capitalism?  whiskey tango foxtrot?  

    Please don't dominate the rap, Jack, if you got nothin' new to say - Grateful Dead

    by Cedwyn on Fri Nov 16, 2012 at 06:39:27 PM PST

  •  This is definitely not good news. (12+ / 0-)

    Bloody hell......

    I don't know enough about what regulatory systems are in place to deal with this sort of acquisition on both federal and state levels.  If there isn't any, there needs to be.  

    My one experience with a hospital being bought by a large corporate entity was the HCA acquisition of the Lawnwood med/surg and psych facilities in my hometown.  In just the last three months, there's been a huge scandal about the cardiologists at that facility.  And I can tell you that, years ago when the acquisition happened, the psych facility was transformed into a substance abuse treatment facility -- not because they had empty beds.  They did it because treating addicts and drunks was far more lucrative than treating the mentally ill.

    I have to say I find it ironic that, just after an election in which voters overwhelmingly rejected the politics of greeed, this story comes to our attention.  This is emblematic of everything wrong with our particular version of capitalism.  I can't call it vulture capitalism -- maybe a better term would be vampire capitalism.

    "Fighting Fascism is Always Cool." -- Amsterdam Weekly, v3, n18 (-8.50, -7.23)

    by Noor B on Fri Nov 16, 2012 at 06:49:41 PM PST

  •  a couple points (12+ / 0-)

    First of all, hospitals and ambulatory surgery centers are very different animals.  ASCs are much more likely to be for-profit enterprises than hospitals.

    Secondly, you are correct--hospitals are being squeezed and draconian budget cuts are being made.  But these are occuring just as frequently and deeply (sometimes more so) in non-profit hospitals as in their for-profit competitors.

    One of the greatest contributors to these cuts in my state (Florida--the only one on which I feel qualified to comment with any authority), is the drastic cuts in Medicaid reimbursement, and our governor's staunch opposition to "Obamacare."  

    Finally--as you state, mergers are becoming more common, as economies of scale are employed in an effort to lower costs.  But not all the M & A activity is in the for-profit sector.  Non-profits are also gobbling up weaker competitors at a rapid rate.  This is not necessarily a bad thing, as studies have shown communities with multiple hospital systems actually have higher health care costs than those with a single system.  

    The much touted "free market" just doesn't work where hospitals are concerned.  People don't choose whether or not to have an appendectomy this week, or shop around for the lowest cost trauma surgeon when they're in the back of an ambulance.

    There is no snooze button on a cat who wants breakfast.

    by puzzled on Fri Nov 16, 2012 at 06:55:29 PM PST

  •  Best Day in Stock Market Ever (6+ / 0-)

    We already have for profit hospital chains...HCA, CHS, HMA, Tenet and many smaller ones. Some publicly traded, some private equity. Some of these chains own 50-100+ individual hospitals. Each of these individual hospitals roughly grosses 100 million to 2 billion a year. Their margin is usually only a couple of percent. I really don't know the average. Wall Street obviously believes that Obamacare is going to be the best thing to ever happen to the for profit hospital business. One good example is CHS..Community Health Services. The day that SCOTUS came through for Obamacare was the single best day for CHS as a publicly traded stock in its history. I think most of the other publicly traded hospital chains had similar results.

  •  They should be nationalized (8+ / 0-)

    before rather than after the vulture capitalists have bled them dry and liquidated them. Unfortunately, I see massive blackmail bailouts in the future as the government pays billions to investors for empty husks of what used to be our hospital system.

  •  Some private equity firms (5+ / 0-)

    have already bough ambulance companies, made their killing, and sold them off to merely avaricious business entities. Some of whose executives know appallingly little about the health care industry and its core values.

  •  Outstanding diary. (4+ / 0-)
    Recommended by:
    Pluto, magnetics, NonnyO, Noor B

    So what can we do to stop this?

    "The ignorant mind, with its infinite afflictions, passions, and evils, is rooted in the three poisons. Greed, anger, and delusion." - Bodhidharma

    by hopesprings on Fri Nov 16, 2012 at 08:36:39 PM PST

  •  Record-Setting Profits... (5+ / 0-)

    ... are coming to insurance, medical, and pharmaceutical corporations.  Actually, they've started with some of the pharmaceutical corporations because of Medicare Part D which came into being under Dumbya.  That law had a clause of "buy private insurance or else."  The new law has "buy private insurance or be charged a fine of $1000."

    We aren't even done paying through the nose for the record-setting profits of the unconstitutional and illegal wars started on behalf of the oil corporations (paid for with our tax dollars) which benefited them, the military-industrial complex, and mercenary corporations.

    Too bad our Congress Critters did not listen to us when we asked for, then begged, then demanded a not-for-profit health insurance option... and all the president and the Congress Critters did was ignore us and let the fucking corporations write the laws.  Too bad $COTU$ was suckered into making the mandate a "tax" payable to the insurance corporations.

    IF people in all three branches of government had ANY brains whatsoever, ALL the legislators would have had to do was turn the whole thing over to Medicare.  The infrastructure is in place, there is NO profit margin to worry about, NO stockholders to pay, it's actually running efficiently (surprise!), and they would have had to set caps on the outrageous costs the hospitals and clinics are charging.  To handle the extra paperwork, they'd have only had to open new offices and hire new personnel (right here in America!) to handle the increase in paperwork.  Think of the jobs that would have been created!  The impact on the economy with their first paychecks would have been instantaneous.

    But did any of them (except Kucinich who had a not-for-profit single-payer health care plan, and a bare handful of others) actually listen to us, the people who elected them???  Noooooooooooo....  They just had to schmooze it up with their corporate buddies and cave to corporations!  Idiots!

    The entire world was warned against the blending of corporations and government years ago.  How quickly they forget the lessons of history..., if they ever studied history, that is....

    That, in its essence, is fascism--ownership of government by an individual, by a group, or by any other controlling private power.
    -- Franklin D. Roosevelt

    Fascism should rightly be called Corporatism, as it is the merger of corporate and government power.
    -- Benito Mussolini

    Fascism, the more it considers and observes the future and the development of humanity, quite apart from political considerations of the moment, believes neither in the possibility nor the utility of perpetual peace.
    -- Benito Mussolini

    I'm sick of attempts to steer this nation from principles evolved in The Age of Reason to hallucinations derived from illiterate herdsmen. ~ Crashing Vor

    by NonnyO on Fri Nov 16, 2012 at 11:01:23 PM PST

    •  You have a point. (1+ / 0-)
      Recommended by:
      NonnyO

      There was a lot of fear-mongering about the job losses in the insurance industry.  I thought it was bullshit, because all of those people could easily have been absorbed by the Medicare administrative services -- and still had slots to fill.

      "Fighting Fascism is Always Cool." -- Amsterdam Weekly, v3, n18 (-8.50, -7.23)

      by Noor B on Sat Nov 17, 2012 at 08:52:29 AM PST

      [ Parent ]

      •  After all the harm corporations have done... (1+ / 0-)
        Recommended by:
        War on Error

        ... I can honestly say I don't give a rat's patootie what happens to them.  They can threaten or fear-monger, or coerce all they want, but as long as they are getting our tax dollars with little or no money coming back to us - and, meanwhile, their rates, like at hospitals and clinics, etc., are going up, up, and up - they have no right to complain.  They'll still get bonuses and shareholders will get money.

        Greedy bastards.

        Meanwhile, we get poorer and poorer.

        American corporations can go cheney themselves.

        We should have a health care system like the three Scandinavian countries do (not-for-profit, caps on prices the medical establishments can charge, single-payer, government-administered).  Paid sick leave, paid parental leave for BOTH parents with 80% salary up to 18 months or two years, job waiting for them when they're ready to go back to work....  Yes, their tax base is high, but since they get a return for their taxes, they don't mind paying the taxes.  Health care is considered a right, not a privilege for the rich.  No one goes bankrupt because of insurance or medical expenses.

        Sweden: Land of the Stay-At-Home Dad
        [Gloria Riviera made an ass of herself partway through this video 'cuz she was asking a father what baby items are.  What an idiot!]

        I'm sick of attempts to steer this nation from principles evolved in The Age of Reason to hallucinations derived from illiterate herdsmen. ~ Crashing Vor

        by NonnyO on Sat Nov 17, 2012 at 10:05:33 AM PST

        [ Parent ]

        •  And Finland (2+ / 0-)
          Recommended by:
          NonnyO, Noor B

          FINLAND: 2nd Happiest & Most Prosperous EU Country. WHY?

          They pay higher taxes, too.

          But they have world leading education through college
          Health care
          About to have NO homelessness

          In short, they get a big bang for the taxe they pay.

          I feel like we get our roads paved every year.  The rest most can't participate in or afford.

          Medicare needs to be extended, imo.  It's 75% privatized or requires odious co-pays.

          It's difficult to be happy knowing so many suffer. We must unite.

          by War on Error on Sat Nov 17, 2012 at 12:08:53 PM PST

          [ Parent ]

          •  Yup... totally agree, esp. your last paragraph (1+ / 0-)
            Recommended by:
            Noor B

            Kindergarten through college is paid for the three Scandinavian countries, too (English as a second language is taught from early grade school through high school and/or college).  I correspond with people from all three countries, so I'm aware of the educational benefits.  If they have to live away from home for college, they get a living stipend to pay rent and buy food, under the reasoning they want the students to study full-time, not be distracted by work.  Another benefit of higher taxes.

            Oh, and when it comes to medical care, if people have to get supplies or equipment (like for handicapped persons), corporations are not allowed to charge above a certain price - by law - and if they're caught doing price gouging, they are prosecuted!  What a novel concept, eh?

            Between medical care, education, paid parental leave for both parents (and men are expected to take that leave, too!), paid childcare for working parents, plus good public transportation and mostly good roads for private transportation, plus Wifi throughout the countries (I think I read that Finland also has access for Wifi throughout their country, too, and knowing some of that is in the very far north where it's colder than a witch's tit in January, that's saying a lot), they get some bang for their buck (or ore or penger, as the case may be).

            Plus they get good TV and radio (ad-free!!!) and a couple of years ago Norway's NRK 2, the least watched channel that featured sports, had 135 hours of a show broadcast live, no ads, of the Hurtigruten ship Nordnorge from Bergen to Kirkenes north of the Arctic Circle, and they had people tuning in on a live webcam feed from around the world - me, among them - and that channel got the highest ratings ever for those 135 hours; they set records for number of viewers.  At every port, people turned out on the docks, no matter what time it was.  Midnight sun that far north means light 24/7.  It was quite wonderful to see the locals coming out in their boats of various sizes "escorting" the ship to port, then once there, people holding signs, school bands or local bands playing, mayors & other local dignitaries giving speeches, and in the very far north, they encountered the royal's ship and the queen was waving at everyone and taking pictures of the ship as they passed each other (imagine a royal person acting like a common tourist - that's how it struck me).  At least two marriage proposals were done by signs on other Hurtigruten ships in ports as some were coming and going (Hurtigruten - the coastal ships that carry people and cargo to the various ports).  The entire voyage is still online.  Follow the red dotted line on the map (you can move the map by clicking on it, and go to any part of the journey by clicking on the red line or the larger square where they pull into ports), and if you go up the Geirangerfjord you'll see some really dramatic sights; people live on little spits of land that are almost impossible to get to up the side of the mountain, and the fjord is straight below if they fall off the ledge.  They also have Eurovision online; Norway hosted it in 2010 after they won in Russia in '09, and I noticed on their menus for the Eurovision page they've added previous years for videos now, too.  (YouTube also has the full shows, both semi-final and final shows, since YouTube now has the ability to put full shows online, or allows it, at any rate; individual clips are still shown, too.)

            Oh, and BTW, the documents genealogy researchers like me use to do our family history are also online clear back to the 1600s in some cases..., free..., thanks to the taxpayers in Norway (the one with the easiest web site to use, the most flexible search engine for the transcribed census and other records, images are a second part of the same web site), and Denmark (two web sites; one for transcribed data, one for the church book records).  Sweden has three web sites for genealogists to use, but they turned it over to corporations.  One was bought out a couple of years ago by Ancestry, but I've not been able to figure out their search engine on that one (someone did some kind of code and whoever invented it is far more impressed with it than I am).  The third and newest one I do know how to use, images are by local parish name, it has digital images instead of microfilm images, it's not indexed, but one can scroll through the records.  One needs a whole lot of data in advance to find anything since names are not indexed.  Best:  they know a heckuva lot more about their patronymic names (which all three countries only stopped using in the late 19th / early 20th century - Iceland and the Faroe Islands still use the patronymic naming system) and how to properly enter them in records than transcribers in America who have no idea what the hell they're doing and put the father's patronym for the child's patronym instead of the proper child's patronym.  FamilySearch has a whole section like that, and it's difficult to tell American newbies that what they have in their genealogy database is all f'd up if they had ancestors from certain parts of Norway and got their info off of FamilySearch where they can't even spell the Norwegian words/names correctly.  Really frustrating.

            In any case, I understand why those countries make the top ten lists every year for best places to live, for most contented, or happiest people.  Everyone has to pay taxes, and they are high taxes..., but no one is denied the right to good/excellent medical care (with paid sick leave, paid parental leave, no one goes bankrupt if they come down with a catastrophic illness), a good education, ability to communicate with the rest of the world, good entertainment on their TVs, ability to easily get around on public transportation.

            Of course, it helps that while they do have national guard duty for all able-bodied persons for a couple of years, they don't dwell on it as a lifestyle, and they don't start illegal or unconstitutional wars or spend all of the money in their treasury, and then additionally borrow money, to invade other countries and maintain military forces in those other countries.

            If the US ever wised up, we could be as fortunate.  I don't see that happening here, however.  At least not within my lifetime (I'm 66, plan to live to 100, but I still don't see any common sense political or tax changes in the US in those 34 years ahead for me).

            I'm sick of attempts to steer this nation from principles evolved in The Age of Reason to hallucinations derived from illiterate herdsmen. ~ Crashing Vor

            by NonnyO on Sat Nov 17, 2012 at 05:26:12 PM PST

            [ Parent ]

  •  But, but....I have no health care. (1+ / 0-)
    Recommended by:
    Noor B

    Where am I going to go for my health care with all the ER's closing?

    "Let us never forget that doing the impossible is the history of this nation....It's how we are as Americans...It's how this country was built"- Michelle Obama

    by blueoregon on Sat Nov 17, 2012 at 01:08:36 AM PST

  •  Sick-Fil-A? (2+ / 0-)
    Recommended by:
    Noor B, War on Error

    Soon, anytime anyone is hospitalized in the U.S., they'll be putting money in the coffers of folks like Romney, the Koch brothers, etc.?

    Sick-Fil-A?

    Maybe Sheldon Adelson will start diversifying his casino management business to include hospitals?

    The Dutch kids' chorus Kinderen voor Kinderen wishes all the world's children freedom from hunger, ignorance, and war.

    by lotlizard on Sat Nov 17, 2012 at 03:49:15 AM PST

  •  good. hospitals are inefficient messes. (0+ / 0-)

    they could use a shake up.

  •  My thoughts? (0+ / 0-)

    Is seeing red considered a "thought"

    Happily envisioning these self-styled "Masters of the Universe" being slowly strangled in a most horrid fashion. Starting with Mr. Potatoe Head.

    Maybe one day the Fourth Estate will take their jobs seriously. Or not..

    by Anthony Page aka SecondComing on Sat Nov 17, 2012 at 09:05:12 AM PST

  •  Nothing new, and actually one of the major drivers (0+ / 0-)

    of inflated health care costs over time, despite claims about "economies of scale" and such.

    An example:

    HealthSouth

    CEO Richard M. Scrushy

    Welcome to HealthSouth

    Owens said that besides him and Scrushy, assistant controller Ken Livesay was present for the meeting at HealthSouth headquarters. Owens, Livesay and 13 others have since pleaded guilty in what prosecutors describe as a $2.7-billion fraud.

    "I'm OK. I'm gonna talk, talk to y'all just real. This conversation did not take place. OK?" Scrushy said on the recording.

    "I understand," responded Owens, who was under subpoena to testify before the SEC at the time.

    "It ain't happened," said Scrushy.

    He continued: "Bill, they ain't got nothing. They didn't ask me nothing about the numbers."

    The SEC had been probing alleged insider trading by Scrushy, and Scrushy said the investigator also asked whether he had signed HealthSouth financial statements and whether they were accurate. Scrushy said he responded that the numbers were correct.

    "That's your answers: 'To the best of my knowledge, everything in this report is accurate,' " Scrushy said. Owens testified that Scrushy was talking to him.

    Jurors in HealthSouth Case Hear FBI Recording of Scrushy

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