Efficiency über alles When Private Equity Takes Over a Nursing Home* After an investment firm bought St. Josephâs Home for the Aged, in Richmond, Virginia, the company reduced staff, removed amenities, and set the stage for a deadly outbreak of COVID-19.
Since the turn of the century, private-equity investment in nursing homes has grown from five billion to a hundred billion dollars. The purpose of such investmentsâtheir so-called value propositionâis to increase efficiency. Management and administrative services can be centralized, and excess costs and staffing trimmed. In the autumn of 2019, Atul Gupta, an economist at the University of Pennsylvania, set out with a team of researchers to measure how these changes affected nursing-home residents. They sifted through more than a hundred private-equity deals that took place between 2004 and 2015, and linked each deal to categories of resident outcomes, such as mobility and self-reported pain intensity. The data revealed a troubling trend: when private-equity firms acquired nursing homes, deaths among residents increased by an average of ten per cent. âAt first, we didnât believe it,â Gupta told me. âWe thought that there was a mistake.â His team reëxamined its models, testing the assumptions that informed them. âBut the result was very robust,â Gupta said.
The war in Ukraine will indeed be a bonanza for the likes of Raytheon and Lockheed Martin. First of all, there will be the contracts to resupply weapons like Raytheonâs Stinger anti-aircraft missile and the Raytheon/Lockheed Martin-produced Javelin anti-tank missile that Washington has already provided to Ukraine by the thousands. The bigger stream of profits, however, will come from assured post-conflict increases in national-security spending here and in Europe justified, at least in part, by the Russian invasion and the disaster thatâs followed.
Indeed, direct arms transfers to Ukraine already reflect only part of the extra money going to U.S. military contractors. This fiscal year alone, they are guaranteed to also reap significant benefits from the Pentagonâs Ukraine Security Assistance Initiative (USAI) and the State Departmentâs Foreign Military Financing (FMF) program, both of which finance the acquisition of American weaponry and other equipment, as well as military training. These have, in fact, been the two primary channels for military aid to Ukraine from the moment the Russians invaded and seized Crimea in 2014. Since then, the United States has committed around $5 billion in security assistance to that country.
According to the State Department, the United States has provided such military aid to help Ukraine âpreserve its territorial integrity, secure its borders, and improve interoperability with NATO.â So, when Russian troops began to mass on the Ukrainian border last year, Washington quickly upped the ante. On March 31, 2021, the U.S. European Command declared a âpotential imminent crisis,â given the estimated 100,000 Russian troops already along that border and within Crimea. As last year ended, the Biden administration had committed $650 million in weaponry to Ukraine, including anti-aircraft and anti-armor equipment like the Raytheon/Lockheed Martin Javelin anti-tank missile.
Despite such elevated levels of American military assistance, Russian troops did indeed invade Ukraine in February. Since then, according to Pentagon reports, the U.S. has committed to giving approximately $2.6 billion in military aid to that country, bringing the Biden administration total to more than $3.2 billion and still rising. (...)
The Pentagon gold mine
For U.S. arms makers, however, the greatest benefits of the war in Ukraine wonât be immediate weapons sales, large as they are, but the changing nature of the ongoing debate over Pentagon spending itself. Of course, the representatives of such companies were already plugging the long-term challenge posed by China, a greatly exaggerated threat, but the Russian invasion is nothing short of manna from heaven for them, the ultimate rallying cry for advocates of greater military outlays. Even before the war, the Pentagon was slated to receive at least $7.3 trillion over the next decade, more than four times the cost of President Bidenâs $1.7 trillion domestic Build Back Better plan, already stymied by members of Congress who labeled it âtoo expensiveâ by far. And keep in mind that, given the current surge in Pentagon spending, that $7.3 trillion could prove a minimal figure.
Employee stock ownership.
And coops, where various stakeholders own the equity, wholesale grocery coops owned by retail members...or even companies like REI.
I was clowning a bit
are you referring to employee stock option plan?
Employee stock ownership.
And coops, where various stakeholders own the equity, wholesale grocery coops owned by retail members...or even companies like REI.
Sorry - in my mind I'm always thinking "democratic socialism." Still - to go back to the beginning - a better idea than capitalism, which runs roughshod over its workers and has no concern for the environment.