SUBSCRIBE TO OUR FREE NEWSLETTER
Daily news & progressive opinion—funded by the people, not the corporations—delivered straight to your inbox.
5
#000000
#FFFFFF
5
#000000
#FFFFFF
tax dodging
For-Profit Healthcare Makes Us Sick!
The harmful behaviors of profit-driven healthcare companies—from tax dodging to insurance denials to carelessness with patient safety—stem from the same illness: a disregard for the community they serve.
Nov 02, 2025
Even though most of us think of healthcare as a human right, the reality is that in the United States the provision of healthcare is big business. It places profits over people, demonstrating that priority through tax dodging, price gouging, insurance denials, and unsafe conditions for patients, as documented in a recent joint report from our two organizations, Americans for Tax Fairness and Community Catalyst.
The report, “Sick Profits,” highlights how seven healthcare corporations have together saved over $34 billion in federal taxes thanks to the 2017 Trump-GOP tax law recently extended by the current Trump administration and Republican Congress. They paid for those corporate tax breaks in part by cutting Medicaid and jeopardizing health coverage for 15 million people, and failing to preserve the enhanced premium tax credits for people buying health insurance through the Affordable Care Act (ACA) Marketplaces.
We currently have public policy that cuts taxes on corporations while ignoring nearly two-thirds of people who believe that big companies are not paying enough. Instead, healthcare corporations have each enjoyed hundreds of millions—in most cases, billions—of dollars in tax savings thanks to the Republican tax law, the most expensive part of which was a two-fifths cut in the corporate tax rate. They have also saved taxes by exploiting loopholes that the law (and its extension) failed to close, including in the accounting for stock options and the treatment of profits shifted offshore.
Not surprisingly, the companies examined in the report did not use their tax savings to lower prices, hire more providers, or improve patient care. No, the money went instead to higher executive compensation and increased payouts to shareholders through dividends and stock buybacks.
We must demand more transparency, fairer tax policy, and better oversight of these institutions.
Additionally, companies are maximizing their profits by simply not paying for care. By demanding “preauthorization” for a dizzying number of procedures then routinely denying approval, insurers can save billions at the expense of their policyholders. High percentages of initial denials are overturned on appeal, showing that “no” is simply the initial default position, taken in the hopes that patients and doctors won’t push the issue. Claim denials often result in medical debt and can also disrupt treatment for chronic medical conditions, delay or deny access to lifesaving care, and lead to avoidable complications—or even death.
Claim denials affect the health and well-being of people every day. They are people like Little John Cupp, who began feeling short of breath and experienced swelling in his feet and ankles. His doctor recommended a catheter exam to determine whether the arteries in his heart were blocked. However, the medical benefits management company EviCore (owned by Cigna) twice denied the catheter exam while eventually approving a much lower-cost stress test. The delay in diagnosis proved catastrophic. Less than two days after Mr. Cupp received the stress test, he died of cardiac arrest.
The tragedy of the end of Mr. Cupp’s life demonstrates the incredibly real risks that the first obstacle to getting care creates. Unfortunately, clearing that hurdle and receiving approval for care does not ensure quality. You could find yourself getting treatment at a facility saving money for shareholders by reducing staff and failing to maintain safe and hygienic conditions. NBC News aired a six-part investigation of hospital-operator HCA Holdings that uncovered, in the words of our report, “roaches in the operating room, leaking ceilings, essentially unmonitored vital signs, overworked nurses, overcrowded emergency rooms, closed departments, and other threats to patient health and safety.”
Or you may receive care at a facility owned or controlled by private equity interests. One cautionary tale is Prospect Medical Holdings, which operated hospitals and other health facilities in multiple states and was driven into bankruptcy after it was acquired by a private equity firm that extracted over $650 million in debt-financed dividends from the targeted company. While the private equity partners enjoyed lucrative payouts, patients suffered from unsanitary conditions, supply shortages, insufficient staffing, and shuttered departments.
Our diagnosis is simple but serious. The harmful behaviors of profit-driven healthcare companies—from tax dodging to insurance denials to carelessness with patient safety—stem from the same illness: a disregard for the community they serve. We must demand more transparency, fairer tax policy, and better oversight of these institutions. That means closing tax loopholes, raising the corporate tax rate, curbing the routine denials of coverage, and strengthening regulatory oversight of health facilities. That’s the only way to ensure that people’s needs are prioritized over corporate profits.
Keep ReadingShow Less
'Wallowing in Corruption': Lobbyist Who Helped Ultra-Rich Dodge Taxes Now Heads Trump Tax Office
"By putting a professional tax dodging consultant in charge of their tax law, Republicans are continuing to make their intentions crystal clear—this law is a gift to billionaires and huge corporations."
Jul 15, 2025
A corporate lobbyist who for decades has helped major companies and rich Americans dodge taxes is now serving as the U.S. Treasury Department's top tax policy official, a position in which he will write rules implementing the newly passed Republican budget law.
That role is "enormously powerful," The New York Times' Jesse Drucker wrote in a Monday profile of Ken Kies, whom the GOP-controlled U.S. Senate confirmed as assistant treasury secretary for tax policy in a party-line vote last month. President Donald Trump selected Kies for the position in January.
The Republican budget measure, which President Donald Trump signed into law earlier this month, contains around $4.5 trillion in tax cuts that will flow disproportionately to the wealthiest Americans over the next decade, according to nonpartisan analysts.
"By putting a professional tax-dodging consultant in charge of their tax law, Republicans are continuing to make their intentions crystal clear—this law is a gift to billionaires and huge corporations like those Ken Kies has spent his career looking out for," Leor Tal, campaign director for the progressive advocacy group Unrig Our Economy, said in a statement Monday.
"As families struggle with rising prices from Trump's tariffs and face devastating cuts to Medicaid and SNAP," Tal added, "Republicans are doubling down on helping the richest of the rich, while working people pay the price."
In his role as a lobbyist whose client list has included Goldman Sachs, Pfizer, Microsoft, and other corporate behemoths, Kies has helped secure major tax giveaways for large companies and wealthy Americans—including in the 2017 Trump-GOP tax law that the new Republican budget package extends.
"In the George W. Bush administration, Mr. Kies successfully pushed for legislation to make such offshore tax dodges even easier to execute. During the Obama administration, he fended off another attempted crackdown on those strategies," Drucker wrote Monday. "In 2017, as part of a sweeping package of tax cuts signed by Mr. Trump, Mr. Kies lobbied for a new tax break that provides a 20% deduction to certain businesses, which overwhelmingly benefits the richest Americans."
Drucker noted that in his new position, Kies "will oversee about 100 attorneys and economists at the Treasury Department's Office of Tax Policy, a powerful corner of the federal government."
"The office issues regulations to help the government administer tax laws and provides guidance that can render the latest tax-dodging strategy a gold mine—or doom it," he added.
Kies previously served as managing director of the Federal Policy Group, a lobbying firm at which he "delivered significant legislative and regulatory results for his clients, which include major corporations, trade associations, and coalitions of companies with common objectives," according to a since-removed biography of Kies.
"Mr. Kies has led coalition efforts to enact legislation responding to the World Trade Organization's ruling against U.S. foreign sales corporation benefits, to avert enactment of broad 'corporate tax shelter' legislation that would have an adverse impact on legitimate business transactions, and to reverse Treasury regulations targeting 'hybrid' arrangements of U.S. multinational corporations, among other projects," the biography stated.
Highlighting the Times profile of Kies, Rep. Pramila Jayapal (D-Wash.) wrote Monday that the Trump administration is "wallowing in corruption."
"Five trillion dollars in tax cuts for the wealthiest, written and administered by the wealthiest," she wrote. "On the backs of stripping healthcare and food from working and poor people. Shame on you."
In addition to implementing the new Trump-GOP law, Kies could be positioned to help deliver another sizable tax break to the rich.
The Washington Post's Jeff Stein reported last week that on the heels of passage of the GOP budget law, right-wing organizations and Republican lawmakers are set to push the Trump administration to unilaterally "drastically reduce what investors pay on their capital gains."
"The plan rests on changing how the Treasury Department calculates those taxes," Stein wrote. "The highest-earning 1% of Americans would receive 86% of the benefits from indexing capital gains to inflation, while the bottom 80% of income earners would get just 1% of the benefits, Penn Wharton projected in 2018."
Rep. Brendan Boyle (D-Pa.), the top Democrat on the House Budget Committee, wrote in response to Stein's reporting that "after gutting health care for millions of Americans and passing massive tax breaks for billionaires, Republicans are now working on even MORE tax breaks for the ultra-rich."
"They aren't interested in fighting for working families—only their rich friends," Boyle added.
Keep ReadingShow Less
Why Corporate Leaders Who Strip Companies for Parts Have No Business in Government
When corporations prioritize shareholder payouts over real investment, society loses—but when governments adopt the same model, the consequences are compounded.
May 13, 2025
There’s a familiar myth in American politics: that of the no-nonsense business leader who cuts through red tape and gets results. It fuels the belief that running a country is just like running a company—and that executives, with their boardroom instincts and bottom-line mindset, are exactly what government needs.
But that myth collapses under the weight of what corporate leadership has actually become—and what happens when it migrates into public office.
Economist William Lazonick has spent decades analyzing that transformation. He argues that corporate America has abandoned its commitment to innovation and productive investment, replacing it with a laser focus on cost-cutting, price gouging, and tax dodging to boost profits so they can do more stock buybacks—all in the name of maximizing shareholder value. Most executives are no longer rewarded for building durable businesses or contributing to the real economy—they’re rewarded for how efficiently they extract value from the companies that they control.
We’re not just talking about fragile companies. We’re talking about the erosion of public institutions, rising inequality, and a democracy that serves fewer and fewer people.
Lazonick calls this model a “scourge,” blaming it for weakening U.S. technological leadership, driving massive inequality, and destabilizing the broader economy. Now, he warns, this same extractive logic is infiltrating the federal government.
The ongoing 2025 budget debates are a case in point. Under the guise of “efficiency” and “fiscal responsibility,” the Trump administration has proposed slashing $163 billion from federal spending—cuts that would gut education, housing, and medical research—all of which are essential for value creation. The language mirrors what executives have long used to justify layoffs, offshoring, and disinvestment. But in this case, it’s not a corporation being hollowed out. It’s the state itself.
Lazonick argues that this shouldn’t surprise anyone. “Because these people have gotten away with looting corporations, they’ve come to believe it’s their right to loot the state,” he says. Even among tech figures who’ve built or have led the building of real products—like Elon Musk, Jeff Bezos, and Mark Zuckerberg—Lazonick notes a mindset of entitlement: “They treat the resulting wealth as entirely their own, as if they alone earned it.” That thinking now shapes public policy, where deregulation and budget cuts benefit the wealthy while dismantling protections for workers and consumers.
Take Musk, for example. As head of the Department of Government Efficiency (DOGE), he’s worked to weaken regulatory agencies like the Consumer Financial Protection Bureau and the National Labor Relations Board—both of which would typically oversee parts of his business empire. At the same time, his companies continue securing massive federal contracts, including a potential $2 billion FAA deal, raising serious concerns about conflicts of interest. As Lazonick and colleague Matt Hopkins argue in a recent piece for the Institute for New Economic Thinking, Musk has advanced through a “perilous system of corporate governance” driven by shareholder primacy—fueling inequality and eroding America’s technological leadership. His tenure at DOGE is simply more of the same: dismantling oversight, channeling public resources into private ventures, and treating government as just another asset to extract.
Musk’s corporate empire—Tesla, SpaceX, and Neuralink—owes much of its success to taxpayer-funded research and government support. Tesla was launched with the help of federal loans and electric vehicle subsidies. SpaceX builds on decades of NASA-funded R&D and now depends on billion-dollar public contracts. Even Neuralink draws heavily on publicly funded neuroscience work. Despite the mythology of private-sector genius, these companies are deeply rooted in public investment. Yet the public sees little return.
And the mindset isn’t limited to Musk. President Donald Trump and his family are taking the corporate model Lazonick describes to new heights, using government as a platform for private enrichment. Eric Trump recently promoted the family’s latest crypto venture, making the president a major crypto player while shaping federal policy toward that very industry. The Trump family’s 60% stake in World Liberty Financial, now attracting major investment, has intensified concerns over conflicts of interest. Meanwhile, under Eric’s leadership, the Trump Organization has struck a controversial $5.5 billion deal with a Qatari state firm to build a luxury golf resort—despite Trump’s previous pledge to avoid foreign deals while in office.
Trump has also issued executive orders to “streamline” federal procurement and contract reviews. While marketed as anti-waste measures, critics see them as a backdoor for directing government business to favored contractors, including those with family ties. The line between public service and private gain has rarely been thinner.
Lazonick warns that the stakes are high. When corporations prioritize shareholder payouts over real investment, society loses—but when governments adopt the same model, the consequences are compounded. We’re not just talking about fragile companies. We’re talking about the erosion of public institutions, rising inequality, and a democracy that serves fewer and fewer people.
To reverse course, Lazonick argues we need deep structural reform in how corporations—and by extension, governments—operate. That means banning stock buybacks; reining in executive compensation tied to manipulated stock performance; and reinvesting profits in innovation, workers, and communities. It means embracing a stakeholder model of governance that sees corporations not just as wealth machines, but as stewards of social value.
Because if we don’t fix these systemic flaws, the looting won’t stop. It’ll only deepen—and spread.
Keep ReadingShow Less
Most Popular