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New Report Outlines Private Equity’s Toll from Nursing Homes to Reproductive Health
A new Public Citizen report released today examines private equity’s toll on U.S. health care in more than a dozen sectors, from end-of-life care and home health care to dentistry and reproductive health. Increased private equity takeovers have come with shocking lapses in safety, with prices rising faster than at non-private equity acquired entities, while patients have been subjected to price gouging schemes.
In the report, Public Citizen calls for action from Congress and the Biden administration to increase oversight and accountability for private equity firms in health care.
Private equity acquisitions in the health care sector have steadily climbed since the financial crisis in 2009, particularly in the past five years. Unlike acquisitions of hospitals, which typically occur under a public spotlight, the private equity industry’s acquisitions of physician practices and other health care business lines often occur with little or no disclosure or public scrutiny, hindering the ability of regulators and watchdogs to monitor the effects of private equity ownership.
“Thanks to a lack of transparency, we don’t know everything about private equities’ incursion into health care. But what we do know is shocking and immoral,” says Eagan Kemp, health care policy advocate at Public Citizen. “The damage that private equity has wrought on Americans’ health care from cradle to grave, simply for profit, has become a life or death situation. Transparency and oversight are needed, stat.”
The report compiles findings from various health care sectors, including:
There are also additional steps the federal government can take to better ensure that health reporting requirements improve transparency and accountability. The Biden administration has already begun to implement additional requirements that would improve transparency of ownership, including publishing the ownership information of thousands of hospitals. Similar efforts in other areas of health care would be a positive step in the direction of oversight and accountability for private equity firms in health care.
In addition, Rep. Pramila Jayapal is expecting to reintroduce the Healthcare Ownership Transparency Act, which will require private equity firms and other financial interests to disclose ownership stakes in health care facilities including nursing homes.
“We applaud Rep. Jayapal’s ongoing effort to shine a light on the dangerous toll private equity vultures are taking on our health,” says Robert Weissman, president of Public Citizen. “Adequate regulation of this predatory industry is acutely critical when it comes to the health care sector.”
Public Citizen is a nonprofit consumer advocacy organization that champions the public interest in the halls of power. We defend democracy, resist corporate power and work to ensure that government works for the people - not for big corporations. Founded in 1971, we now have 500,000 members and supporters throughout the country.(202) 588-1000
"This is a desperately dark day for LGBTI rights and for Uganda," said Amnesty International's deputy regional director for East and Southern Africa.
Human rights defenders around the world on Monday condemned Ugandan President Yoweri Museveni after he signed a bill criminalizing same-sex sexual acts between consenting adults and imposing the death penalty for "aggravated homosexuality."
Museveni, who is 78 and has ruled the African nation for nearly four decades, signed the Anti-Homosexuality Bill of 2023, under which people convicted of "aggravated homosexuality"—that is, same-sex sexual acts by HIV-positive people or with children, disabled people, or anyone deemed vulnerable—can be hanged to death. The law punishes same-sex acts with life imprisonment and attempted same-sex acts with 10 years behind bars. It also criminalizes the "promotion" of LGBTQ+ rights.
The bill was initially rejected by Museveni last month because he wanted it amended to include a "rehabilitation" option for LGBTQ+ people who "would like to live normal lives again," according to a presidential spokesperson. The legislation builds on a 2013 law under which life imprisonment was the most severe penalty for same-sex relations. Museveni has said that he finds gay people "disgusting."
"Despite our concerted efforts to stop the passage of the Anti-Homosexuality Bill, the president today has legalized state-sponsored homophobia and transphobia by signing this bill into law," Frank Mugisha, executive director of the advocacy group Sexual Minorities Uganda (SMUG), said in a statement.
"It will erode the rights of LGBTIQ individuals and put innocent Ugandans at crosshairs of grave violations from state and nonstate actors," Mugisha added. "We now look forward to the legal challenge in court, and the law being repealed."
Hours after Museveni signed the bill into law, 11 opponents including Ugandan parliamentary lawmaker Fox Odoi-Oywelowo petitioned the Constitutional Court seeking to block its implementation, the Monitorreports.
\u201cJoint statement by the leaders of the @GlobalFund, UNAIDS and @PEPFAR on #Uganda\u2019s Anti-Homosexuality Act 2023. \n\nRead statement - https://t.co/1xkDKdm2f5\u201d— UNAIDS (@UNAIDS) 1685348829
Amnesty International deputy regional director for East and Southern Africa Flavia Mwangovya said in a statement that "this is a desperately dark day for LGBTI rights and for Uganda."
"The signing of this deeply repressive law is a grave assault on human rights and the constitution of Uganda and the regional and international human rights instruments to which Uganda is a part," she continued.
"The Anti-Homosexuality Bill of 2023 will do nothing other than enshrine discrimination, hatred, and prejudice against LGBTI Ugandans and their allies into law," Mwangovya added. "It's unconscionable that they risk losing their lives, their freedom, their privacy, their freedom of expression, and their ability to live free from discrimination."
The United Nations Human Rights Council tweeted: "We are appalled that the draconian and discriminatory anti-gay bill is now law. It is a recipe for systematic violations of the rights of LGBT people and the wider population. It conflicts with the [Ugandan] Constitution and international treaties and requires urgent judicial review."
\u201c"I am deeply concerned about the consequences of Uganda's Anti-Homosexuality Act 2023. This law violates basic human rights and sets a dangerous precedent for discrimination and persecution against the LGBTQ+ community. Let us stand together in solidarity and fight against\u2026\u201d— Steven Kabuye (@Steven Kabuye) 1685348680
Josep Borrell, the European Union's high representative for foreign affairs and security policy, called the new law "contrary to international human rights law and to Uganda's obligations under the African Charter on Human and People's Rights, including commitments on dignity and nondiscrimination, and the prohibition of cruel, inhuman, or degrading punishment."
In the United States—which gives Uganda about $1 billion in annual assistance—President Joe Biden said in a statement that "the enactment of Uganda's Anti-Homosexuality Act is a tragic violation of universal human rights."
"I join with people around the world—including many in Uganda—in calling for its immediate repeal," Biden continued. "No one should have to live in constant fear for their life or being subjected to violence and discrimination. It is wrong."
\u201c\ud835\udc01\ud835\udc2b\ud835\udc1e\ud835\udc1a\ud835\udc24\ud835\udc22\ud835\udc27\ud835\udc20: President @JoeBiden has asked the National Security Council to evaluate the effects of the enactment of Uganda\u2019s Anti-Homosexuality Act and reevaluate annual $1 billion aid to Uganda.\n\n\u201cI have directed my National Security Council to evaluate the implications of\u2026\u201d— Remmy Bahati (@Remmy Bahati) 1685383924
"This shameful act is the latest development in an alarming trend of human rights abuses and corruption in Uganda," Biden asserted, adding that his administration is considering "sanctions and restriction of entry into the United States against anyone involved in serious human rights abuses or corruption."
Ugandan Parliamentary Speaker Anita Among said her U.S. visa had been revoked.
Even some congressional Republicans—some of whom back anti-LGBTQ+ legislation in the United States—condemned the new Ugandan law, including Sen. Ted Cruz of Texas, who called it "grotesque and an abomination."
\u201cUganda\u2019s President has signed this anti-gay legislation into law. Canada\u2019s stance has not changed: This law is appalling and abhorrent, and we strongly condemn it. We\u2019ll continue to stand with 2SLGBTQI+ people \u2013 and stand up for 2SLGBTQI+ rights \u2013 at home and abroad.\u201d— Justin Trudeau (@Justin Trudeau) 1685393570
Same-sex sexual acts were already illegal in Uganda—one of around 30 African and 60 world nations that criminalize such acts— under the 2013 law and legislation passed during colonization by Britain. Prior to colonization's imported homophobia, Uganda had a history of tolerating sexual diversity, including among the Baganda—the country's largest ethnic group—and Lango, who recognize a third gender, the mudoko dako. King Mwanda II, who ruled the Baganda people in the 1880s, was famously bisexual.
Right-wing evangelical Christians from the United States have played a key role in the introduction of anti-LGBTQ+ legislation in African nations.
\u201cFoiled in the United States, anti-gay evangelicals spread hate in Africa: http://t.co/5igFdIhF7z\u201d— Mother Jones (@Mother Jones) 1373455859
Attacks on LGBTQ+ rights and people—including the murders of activists including David Kato and Brian Wasswa—have increased in Uganda this century.
Mugisha said the new law will "bring a lot of harm" to Uganda's already persecuted LGBTQ+ community.
"We feel so, so, so worried," he toldAgence-France Presse.
"This report makes it clear: We must act now to save lives, help people adapt to a changing climate, and ultimately prevent famine," said the World Food Program chief. "If we don't, the results will be catastrophic."
As El Niño looms and fighting in Sudan rages on, a pair of United Nations agencies on Monday warned that "acute food insecurity is likely to deteriorate further in 18 hunger hot spots" across 22 countries from June to November.
The Food and Agriculture Organization (FAO) and the World Food Program (WFP) delivered that warning in a joint report.
"Afghanistan, Nigeria, Somalia, South Sudan, and Yemen remain at the highest concern level," the report states. "Haiti, the Sahel (Burkina Faso and Mali), and the Sudan have been elevated to the highest concern levels; this is due to severe movement restrictions of people and goods in Haiti, as well as in Burkina Faso and Mali, and the recent eruption of conflict in the Sudan."
"Pakistan, the Central African Republic, Ethiopia, Kenya, the Democratic Republic of the Congo, and the Syrian Arab Republic are hot spots with very high concern, and the warning is also extended to Myanmar," the publication continues. "Lebanon, El Salvador, and Nicaragua have been added to the list of hunger hot spot countries, since the September 2022 edition. Malawi, Guatemala, and Honduras remain hunger hot spot countries."
\u201c\ud83d\udd34 Acute food insecurity set to worsen in 18 #HungerHotspots across 22 countries - \ud83c\udd95 @FAO @WFP report warns.\n\nBurkina Faso, Haiti, Mali, the Sudan have been elevated to the highest alert level to join Afghanistan, Nigeria, Somalia, South Sudan & Yemen.\n\n\ud83d\udc49https://t.co/0BDI7Eg8aT\u201d— FAO Newsroom (@FAO Newsroom) 1685352200
The document stresses that worsening conditions in the hot spots occur in the context of a "global food crisis," so "the countries and situations covered in this report highlight the most significant deteriorations of hunger expected in the outlook period" but do not represent all nations facing high levels of acute food insecurity.
"Conflict will disrupt livelihoods—including agricultural activities and commercial trade—as people are either directly attacked or flee the prospect of attacks, or face movement restrictions and administrative impediments," the report states. "New emerging conflicts, in particular the eruption of conflict in the Sudan, will likely drive global conflict trends and impact several neighboring countries."
"The use of explosive ordnance and siege tactics in several hunger hot spots continues to push people into catastrophic levels of acute food insecurity," the document adds, "highlighting the critical role of humanitarian access in preventing the worst outcomes of hunger."
The new report notably came as the WFP announced that on Saturday, six weeks since the fighting broke out in Sudan—displacing nearly 1.4 million people—the U.N. program was able to begin distributing food assistance to the thousands affected by the conflict in and around the capital Khartoum.
"This is a major breakthrough. We have finally been able to help families who are stuck in Khartoum and struggling to make it through each day as food and basic supplies dwindle," said Eddie Rowe, WFP's country director in Sudan, in a statement.
"We have been working round-the-clock to reach people in Khartoum since the fighting began," Rowe added. "A window opened late last week which allowed us to start food distributions. WFP must do more, but that depends on the parties to the conflict and the security and access they realistically guarantee on the ground."
\u201c\ud83c\udd95BREAKTHROUGH: The first distributions of WFP food assistance took place in #Khartoum, Sudan for thousands of people trapped since fighting broke out six weeks ago. \n\nThe distributions come in the last days of a ceasefire set to expire Monday.\u201d— World Food Programme (@World Food Programme) 1685382400
Along with armed conflict, drivers of the deterioration in the report's focal regions include economic issues and the climate emergency. The publication points out that last year, "economic risks were driving hunger in more countries than conflict was," and "the global economy is expected to slow down in 2023—amid monetary tightening in advanced economies—increasing the cost of credit."
"Weather extremes, such as heavy rains, tropical storms, cyclones, flooding, drought, and increased climate variability, remain significant drivers in some countries and regions," the document explains, noting that experts anticipate El Niño conditions—or the warming of sea surface temperatures across the tropical Pacific Ocean—in the months ahead, "with significant implications for several hunger hot spots."
The report emphasizes that "urgent and scaled‑up assistance" in all hot spots "is essential to avert a further deterioration of acute food insecurity and malnutrition," and in some cases, "humanitarian actions are critical in preventing further starvation and death."
\u201cHUNGER HOTSPOTS: \n\n\ud83d\udd34A new report warns urgent assistance is required to protect lives and livelihoods and increase access to food.\n\n\ud83d\udd34The report identifies 18 regions where people are at the most risk of extreme hunger and malnutrition.\n\n\ud83d\udd17https://t.co/HOFGtpjJ5i\u201d— World Food Programme (@World Food Programme) 1685355300
Agency leaders echoed the publication's call to action. Cindy McCain, WFP's executive director, said in a statement that "not only are more people in more places around the world going hungry, but the severity of the hunger they face is worse than ever."
"This report makes it clear: Ae must act now to save lives, help people adapt to a changing climate, and ultimately prevent famine," McCain declared. "If we don't, the results will be catastrophic."
FAO's director-general, Qu Dongyu, stressed that "business-as-usual pathways are no longer an option in today's risk landscape if we want to achieve global food security for all, ensuring that no one is left behind."
"We need to provide immediate time-sensitive agricultural interventions to pull people from the brink of hunger, help them rebuild their lives, and provide long-term solutions to address the root causes of food insecurity," he said. "Investing in disaster risk reduction in the agriculture sector can unlock significant resilience dividends and must be scaled up."
"These bills are not about election reform," said one Harris County official. "They are entirely about suppressing voters' voices."
Harris County Judge Lina Hidalgo on Sunday warned that Republican state legislators had made a "shameless power grab" by passing a pair of bills aimed at allowing the state government to take control of elections in the Democratic stronghold, which includes Houston.
Senate Bill 1933 passed on Sunday as the state's legislative session came to a close, with lawmakers sending to GOP Gov. Greg Abbott's desk a bill that could give Secretary of State Jane Nelson—who was nominated by the governor and confirmed by the state Senate—the authority to run elections under circumstances in any county with more than 3.5 million residents.
The legislation was passed two days after Senate Bill 1750, which also applies to counties above that population threshold and would abolish the nonpartisan county elections administrator position.
Harris County, which President Joe Biden won by 13 points in 2020, is the only county is Texas with a population above 3.5 million, making both bills apply only to its elections.
Hidalgo denounced the legislation as two "election subversion bills" and warned that they will set a "dangerous precedent" for Republican governors who wish to take control of voting in heavily Democratic counties.
\u201cThe two Texas election subversion bills have now passed. They remove Harris County\u2019s nonpartisan Election Administrator and empower a Republican state official to micromanage elections in Texas\u2019 largest (Democratic) County. This is a shameless power grab and dangerous precedent.\u201d— Lina Hidalgo (@Lina Hidalgo) 1685331039
"These bills are not about election reform," said Hidalgo at a press conference last week, as the legislation was advancing. "They're not about improving voters' experience. They are entirely about suppressing voters' voices. The reasoning behind these bills is nothing but a cynical charade."
Hidalgo and other officials said at that event that they plan to file a lawsuit against Abbott's administration if the governor signs the bills into law. The Texas Constitution bars state lawmakers from passing laws that apply only to specific jurisdictions, but Republicans' use of a population threshold instead of naming Harris County itself in the legislation may be used at their defense if the lawsuit moves forward.
S.B. 1750 requires Harris County to change how its elections are overseen starting September 1, when Houston will be two months away from voting for its next mayor. Harris County Clerk Teneshia Hudspeth and County Assessor Ann Harris Bennett will oversee elections in the county starting in September.
If, after Hudspeth and Bennett take over, Nelson finds "good cause to believe that a recurring pattern of problems with election administration or voter registration exists in the county," the secretary of state would be permitted to take legal action to remove the two women from office and to install members of her staff in the county's election offices.
Republicans have said Harris County didn't have enough poll workers in the March 2022 primary and that polling locations opened late and ran out of ballots during the November 2022 general election.
"The fact of the matter is, there has not been a single successful lawsuit that proves that there were any kind of problems," said Hidalgo on Sunday. "And I hope that anybody talking about this understands that you are amplifying exaggerations and rumors when you repeat the excuses that these folks are using."
\u201cAs intriguing as an impeachment of the Texas Attorney General is, we can\u2019t lose sight of the fact that legislators in Texas are still trying to disenfranchise 4.7 million of their own constituents by taking over elections in Harris County. This fight is far from over.\u201d— Lina Hidalgo (@Lina Hidalgo) 1685308988
The legislation was passed two-and-a-half months after Abbott's administration announced its takeover of the Houston Independent School District, which has made recent improvements in academic performance that were achieved despite chronic underfunding.
"Houstonians," Emily Eby French, a staff voting rights attorney at the Texas Civil Rights Project, said last week, "will soon live in a different Texas than the rest of us."