Cory Doctorow sul suo blog descrive le opacità legate al private equity nell’economia americana: molte operazioni legate a questa attività sarebbero finalizzate a un vero e proprio “spolpamento” di società economicamente solide in modo da avvantaggiare la concorrenza, con ricadute disastrose sui dipendenti e sul tessuto sociale.

Fans of the Sopranos will remember the “bust out” as a mob tactic in which a business is taken over, loaded up with debt, and driven into the ground, wrecking the lives of the business’s workers, customers and suppliers. When the mafia does this, we call it a bust out; when Wall Street does it, we call it “private equity.”

It’s a good racket – for the racketeers. Private equity has grown from a finance sideshow to Wall Street’s apex predator, and it’s devouring the real economy through a string of audactious bust outs, each more consequential and depraved than the last.

As PE shows that it can turn profitable businesses gigantic windfalls, sticking the rest of us with the job of sorting out the smoking craters they leave behind, more and more investors are piling in. Today, the PE sector loves a rollup, which is when they buy several related businesses and merge them into one firm. The nominal business-case for a rollup is that the new, bigger firm is more “efficient.” In reality, a rollup’s strength is in eliminating competition. When all the pet groomers, or funeral homes, or urgent care clinics for ten miles share the same owner, they can raise prices, lower wages, and fuck over suppliers.

Lo spolpamento indotto dalle società di private equity avrebbe riguardato svariati settori, come quello relativo alla gestione delle carceri e delle mense scolastiche e in modo più massiccio, l’ambito sanitario, con operazioni di acquisizione per oltre un triliardo di dollari dal 2012 ad oggi.
Secondo Doctorow, oltre all’aumento di frodi sanitarie, interventi non necessari e tagli al personale e agli stipendi, gli effetti peggiori delle acquisizioni avrebbero riguardato le case di riposo, le residenze per pazienti psichiatrici e gli hospice, che avrebbero una particolare attrattività per via della scarsità di controlli e di obblighi legislativi verso i pazienti oltre che a una bassa possibilità di incorrere in azioni legali.

Medicare pays private hospices $203-$1,462 per day to take care of dying old people – seniors that a doctor has certified to have less than six months left. That comes to $22.4b/year in public transfers to private hospices. If hospices charge that $1,462 day-rate, they have lots of duties, like providing eight hours’ worth of home care. But if the hospice is content to take the $203/day rate, they are not required to do anything. Literally. It’s just free money for whatever the operator feels like doing for a dying elderly person, including doing nothing at all.

As Appelbaum told Maureen Tkacik for her excellent writeup in The American Prospect: “Why anybody commits fraud is a mystery to me, because you can make so much money playing within the guidelines the way the payment scheme operates.”

This is absolute catnip for private equity – free government money, no obligations, no enforcement, and the people you harm are literally dying and can’t complain. What’s not to like? No wonder PE companies have spent billions “rolling up” hospices across the country.