Asked to name their top two priorities for policymakers on maternal health, registered voters put preventing maternal deaths first, at 32 percent, ahead of early care and intervention during pregnancy at 22 percent.
The survey, released July 30 by the advocacy organization Healthy Moms, Healthy Babies America and conducted by KAConsulting, polled 1,001 registered voters nationwide between July 12 and 16, with a margin of error of plus or minus 3 percentage points. Because it was commissioned by an organization advocating for maternal health policy, its framing and question wording reflect that purpose, and the findings should be read as advocacy polling rather than independent research.
What makes the result worth reporting is that federal surveillance data exist to check it against. Opinion tells you what people want addressed. Vital statistics tell you what is actually happening.
The Federal Numbers Behind the Priority
The National Center for Health Statistics published final 2024 maternal mortality data in March. In 2024, 649 women died from maternal causes in the United States, compared with 669 the year before. The rate was 17.9 deaths per 100,000 live births, which NCHS described as not significantly lower than the 2023 rate of 18.6.
That word matters. The apparent decline is within the range of statistical noise. NCHS notes that maternal mortality rates fluctuate year to year because the absolute number of events is relatively small, and because accuracy in recording maternal deaths on death certificates remains an ongoing data-quality problem the agency is still working on.
The disparities are larger than the year-to-year movement. For Black non-Hispanic women, the 2024 rate was 44.8 deaths per 100,000 live births, three times the rate of 14.2 for white non-Hispanic women. Changes from 2023 to 2024 across racial groups were not statistically significant.
Age is the other major gradient. Women 40 and older had a maternal mortality rate of 62.3 per 100,000, nearly five times the rate of 13.7 among women younger than 25. Women aged 25 to 39 fell at 16.5.
Two Different Federal Counts, and Only One Measures Preventability
Readers encountering different maternal death figures are usually seeing two separate systems, and the distinction matters for the question the poll asked.
The NCHS figures above count maternal deaths, defined internationally as deaths during pregnancy or within 42 days of the end of pregnancy from causes related to pregnancy. That is a vital statistics count drawn from death certificates.
A second system, Maternal Mortality Review Committees, examines pregnancy-related deaths, which include deaths up to one full year after the end of pregnancy. These committees are multidisciplinary panels that review individual cases in detail, and they are the only source that assigns preventability determinations and issues recommendations. CDC funds this work through the ERASE MM program, which supports committees across most states and territories.
That second system is what the poll’s language about “preventing” maternal deaths actually maps onto. A vital statistics count establishes how many women died. A review committee establishes whether the death could have been avoided and what would have changed the outcome. Congress reauthorized the Preventing Maternal Deaths Act in February 2026 through 2030, with $113.5 million appropriated to the account funding this work.
Where the Poll and the Data Line Up
Several of the specific policies voters endorsed correspond to problems the surveillance data identify.
Eighty-eight percent of respondents supported expanding specialty care and telehealth for women with high-risk pregnancies in rural and underserved communities. Access to risk-appropriate care is a recurring theme in review committee findings, and rural obstetric unit closures have lengthened travel distances for delivery in many states.
Eighty-seven percent supported a whole-health approach including maternal mental health, nutrition, and chronic disease management. That aligns with the extended one-year window review committees use, since deaths in the later postpartum period frequently involve mental health conditions, substance use, and cardiovascular disease rather than delivery complications.
Across 15 policy proposals tested, 13 drew support from at least 80 percent of respondents, all 15 drew at least 72 percent, and 79 percent said they would be more likely to vote for a candidate supporting them. Fifty-five percent held an unfavorable view of the U.S. health care system overall, and 51 percent viewed it unfavorably specifically on care for women.
One figure in the poll should be handled carefully. Seventy-two percent said they were more likely to support reforms after being told maternal mortality and morbidity cost the economy $165 billion in 2020. Questions that present a fact before asking for a response measure persuasion, not baseline opinion, and should not be reported as if they measured the latter.
What Patients and Families Can Do with This
Nothing in polling changes an individual’s risk. What does change outcomes is recognizing warning signs and being heard when reporting them.
CDC’s Hear Her campaign identifies urgent maternal warning signs that warrant immediate care during pregnancy and for a full year afterward. They include severe headache that will not go away, changes in vision, trouble breathing, chest pain or a racing heart, severe belly pain, a fever of 100.4 degrees or higher, extreme swelling of hands or face, thoughts of harming oneself or the baby, and heavy bleeding.
The one-year window is the part most often missed. Postpartum visits frequently stop at six weeks, while a substantial share of pregnancy-related deaths occur later. Anyone who gave birth within the past year and develops these symptoms should say so explicitly when seeking care, because clinicians who do not know about a recent pregnancy may not consider pregnancy-related causes.
Practical steps include identifying the nearest hospital with obstetric capability before delivery, particularly in rural areas, and asking about postpartum Medicaid coverage, which most states have extended to 12 months. Patients whose symptoms are dismissed can ask for the concern to be documented in the chart, request a second opinion, or contact the hospital’s patient advocate.
What happens next is a data question. NCHS publishes provisional maternal mortality estimates on a rolling basis and final annual figures with roughly a 15-month lag, meaning 2025 final data are not yet available. Whether the flat trend of the past two years turns into a genuine decline will not be answerable for at least another year.
Frequently Asked Questions
What did the poll find? Registered voters named preventing maternal deaths their top maternal health priority for policymakers at 32 percent, followed by early care and intervention during pregnancy at 22 percent.
Who conducted it? KAConsulting for Healthy Moms, Healthy Babies America, an advocacy organization. It surveyed 1,001 registered voters July 12 to 16, 2026, with a margin of error of 3 percentage points.
How many women die from maternal causes? Federal data recorded 649 maternal deaths in 2024, a rate of 17.9 per 100,000 live births, which NCHS said was not significantly different from 2023.
How large are the racial disparities? Black non-Hispanic women had a rate of 44.8 deaths per 100,000 live births in 2024, three times the rate of 14.2 among white non-Hispanic women.
Why do different maternal death numbers circulate? Vital statistics count deaths within 42 days of pregnancy. Maternal Mortality Review Committees examine pregnancy-related deaths up to one year afterward and assess preventability.
What warning signs require immediate care? Severe persistent headache, vision changes, trouble breathing, chest pain, severe belly pain, fever of 100.4 or higher, extreme swelling, heavy bleeding, or thoughts of self-harm during pregnancy and for a year after.
How long does postpartum risk last? Up to a full year. Anyone who gave birth in the past 12 months should tell clinicians about the pregnancy when seeking care for new symptoms.
The last half-century has brought major leaps in medical technology. Sophisticated scans, cutting-edge tests, and an ever-expanding menu of supplements have transformed how illness is detected and treated. Yet, paradoxically, many argue that the ‘art’ of medicine, the attentive listening, the focus on whole-body wellness, has slipped into the shadows. For countless patients, technology now speaks louder than the human touch.
Dr. Robin H. Miller, an integrative medicine physician and author, believes that this imbalance has come at a cost. “Our medical system is broken,” she says. “It was flawed before the pandemic and only grew worse after COVID. Too many patients have fallen through the cracks.” Her conclusion is simple, but urgent: individuals must become their own partners in health. Doctors and hospitals are critical when crises strike, but prevention and daily wellness rest in each person’s hands.
It is this conviction that people themselves hold the power to stay well that drives Miller’s work today. And it is the reason she decided to do something unconventional: create a series of books that makes medicine accessible, relatable, and even enjoyable.
Miller’s path to this mission began in the halls of a hospital, where she trained in preventative cardiology. Helping families break cycles of heart disease inspired her, but a move to Oregon and the realities of standard practice soon tempered that optimism. Ten-minute appointments, rushed conversations, and quick fixes left her questioning whether she was truly helping people.
So she pivoted. Miller pursued an integrative medicine fellowship and launched Triune Integrative Medicine, a clinic centered on hour-long visits, deep listening, and wellness-focused care. The results spoke for themselves. “Most of the time, patients will tell you what’s wrong if you listen,” she explains. That philosophy not only improved outcomes but also rekindled her passion for medicine.
Her work extended beyond the clinic. As host of NBC5’s Focus on Health, she reached thousands each week. She also developed a course, The Scientific Guide to Health and Happiness. And even turned to writing, first traditional guides, and later a creative series.
Miller knew from experience that patients often tune out traditional medical advice. “Adults don’t always listen to their doctors. They listen to friends, family, or social media,” she says. To bridge that gap, she returned to a childhood classic: Dick and Jane.
Her new series, ‘A Healthy Journey with Dick and Jane,’ translates complex health concepts into simple, illustrated stories. Using humor, bite-sized explanations, and even AI-generated visuals, the books invite readers to explore topics like heart health, gut health, brain function, and more, without the intimidation of jargon or the pressure of clinical authority.
The series includes Mind Your Health, The Beat Goes On, Gut Instinct, Solid Ground, Skin Health, and Health 101: A Healthy Journey with Dick and Jane. The upcoming one will be on menopause, demystifying one of the most misunderstood stages of women’s health.
By weaving evidence-based advice into the familiar rhythms of Dick and Jane storytelling, Miller lowers the barrier to entry. “Health isn’t complicated,” she insists. “But you have to do it. You have to be motivated, and sometimes that means making it fun.”
The wellness industry is booming, but Miller sees danger in the noise. Every online search brings conflicting answers. Every company promises a miracle supplement or device. The overload leaves people confused, frustrated, and often paralyzed.
Miller’s counterpoint is clarity. Her books focus on timeless basics, moving your body, eating a Mediterranean-style diet, prioritizing sleep, reducing stress, and cultivating community. No fad diets. No magic pills. Just sustainable habits that empower individuals to prevent disease before it starts.
And importantly, her approach emphasizes individuality. “Everyone is unique. What works for one person may not work for another,” she says. “The goal is to give people options and help them discover their own path.”
For Miller, the book series is not the final word, but the beginning of a movement. It is a way of changing the mindset from dependency on a faltering system to personal agency in health. She sees it as a model for how society at large can approach not just medicine, but any area where institutional trust is eroding.
In a time when medicine often feels more mechanical than human, Miller’s message is refreshingly direct: “We already have the tools to heal, we just need to use them.”
Home / News / Private equity’s appetite for hospitals may put patients at risk
Illustration: Traci Daberko
In the wake of the Steward Health Care crisis, corporate and private equity ownership of health care has come under new scrutiny. Here, Harvard health policy experts weigh in on the growing corporatization of the U.S. health care system and what it means for patients, practitioners, and public health.
Throughout 2024, eye-opening news headlines from around the country trained a spotlight on the collapse of Steward Health Care:
As Steward hospitals teeter, CEO’s $40 million yacht is docked in the Galapagos Islands
Sick patients collapsed waiting for care in overwhelmed Steward hospital’s emergency department
Steward Health Care files for Chapter 11 bankruptcy
Steward owned more than 30 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, and Texas. Its volatility and eventual crash jeopardized access to health care for millions of patients.
How did Steward, at one point the largest private for-profit health system in the U.S., go belly up?
The long and short: In 2010, private equity firm Cerberus Capital Management purchased Caritas Christi Health Care, a struggling eastern Massachusetts hospital system, from the Archdiocese of Boston, converting it from non-profit to for-profit and rebranding it as Steward Health Care. In 2016, after years of continued financial instability, Steward signed a sale-leaseback agreement with Medical Properties Trust (MPT), selling the land and buildings occupied by its hospitals to the real estate investment trust then leasing them back. Steward made $1.25 billion from the agreement—enough to steady its financial footing, pay off Cerberus, and fund a growth spree. The next year, the company purchased 26 more hospitals across the country. But with the agreement came what many viewed as inflated rents.
By 2020, Cerberus, having made $800 million in profit on its initial investment, decided to sell Steward hospitals to a group of its physicians, essentially transferring ownership back to Steward’s management team, led by CEO Ralph de la Torre. Over the next several years, concerns about patient care and safety at Steward hospitals mounted as the company opted to cut costs and neglect bills in order to keep up with its rent payments to MPT. In January 2024, MPT announced that Steward was $50 million behind on those payments. By May, the company filed for bankruptcy. Financial documents made clear that the company had paid hundreds of millions to investors and leadership, including de la Torre, who enjoyed a lavish lifestyle while patients at Steward hospitals faced increasingly unsafe conditions. De la Torre was subpoenaed by Congress in July; he failed to appear.
After months of tense negotiations between state governments, Steward, MPT, and potential buyers, by November, most Steward hospitals had found new owners, a mix of non- and for-profit hospital systems and private equity firms. But two hospitals didn’t survive: Carney Hospital, which served Boston’s low-income, majority Black and Hispanic southern neighborhoods, and Nashoba Valley Medical Center, which served 17 suburban and rural communities across central Massachusetts. Thousands of patients and hundreds of staff have been left to find health care and jobs with new providers farther away.
The Steward meltdown has captured the attention of the public and policymakers not as an outlier, but as an object lesson. Its story shines a light on the growing role of private equity in the U.S. health system, helps explain rising discontent among patients and clinicians, and lays bare the dangers of prioritizing profits over people in health care.
A ‘core contradiction’
John McDonough, professor of the practice of public health at Harvard Chan School, calls private equity “the sharp end of capitalism.”
“It’s otherwise often described as ‘capitalism on steroids,’” McDonough said. “It’s for-profit business in its most aggressive form. [Private equity firms] seek returns on their investment as high as possible as quickly as possible, then rush to sell off that investment and go on to their next conquest.”
After decades establishing a presence everywhere from manufacturing, to telecommunications, to grocery stores, in the mid 2000s private equity firms began targeting health care. It was a natural next step: The industry is worth nearly $5 trillion in the U.S., offering significant, dependable cash flow. Firms saw the potential for profits and began buying up physician practices and health facilities, from hospitals to nursing homes to fertility clinics, looking to at least double their initial investment and then sell within a short time, often three to seven years.
Private equity’s foothold in health care has continued to grow. In 2021, according to researchers at UC Berkeley, 5,779 physician practices, specializing in everything from primary care to oncology, were owned by private equity firms—up from 816 in 2012. Nonprofit watchdog the Private Equity Stakeholder Project (PESP) reported that, as of February 2024, nearly 460 U.S. hospitals were owned by private equity firms. These hospitals—which include non-specialty acute care hospitals, rehabilitation hospitals, psychiatric facilities, and long-term acute care facilities—represent 8% of all private (not owned by the government) hospitals and 22% of for-profit hospitals.
5,779
physician practices were owned by private equity in 2021—up from 816 in 2012
22%
of for-profit hospitals—460 in total—are currently owned by private equity
80%
of physicians are employed by a hospital system or corporation—up from 60% in 2019
But ownership by private equity is just the latest version of capitalism’s creep into health care. Its way was paved by corporations entering the industry in the 1980s as an era of free market fundamentalism emerged and the “maximizing shareholder value” movement began to boom. Publicly traded companies began buying up hospitals and health facilities, as well as physicians and physician practices, to establish their own health systems. Today, nearly a quarter of U.S. hospitals are run by for-profit entities that promise to bring business smarts and a flow of capital to health care delivery.
“The pitch is that corporations can raise capital and invest in improving the business—quality of care, operations, professional management—in a way non-profits can’t,” said Meredith Rosenthal, C. Boyden Gray Professor of Health Economics and Policy. “But the challenge is that because health care is so important, the public expects these corporations to prioritize public interest over profits. And that’s not what they’re built to do.”
Because health care is so important, the public expects corporations to prioritize public interest over profits. And that’s not what they’re built to do.
Meredith Rosenthal, C. Boyden Gray Professor of Health Economics and Policy
“Medical care has always had a for-profit element. Physicians were mostly small businesspeople,” McDonough said. “But there’s a difference between a sole proprietor or small business and a mega-corporation that believes its only purpose in the world is return on equity to shareholders. Hold that belief up against a medical provider’s belief that patients come first, and right away there’s conflict. It’s this core contradiction that I think American society has never sufficiently grappled with.”
Non-profits like profits, too
It’s not just corporate health care providers producing this dilemma. Non-profits, which remain the majority of U.S. hospitals and health care facilities, sometimes prioritize profits over their social missions—and community benefit requirement cementing their tax-exempt status—in order to grow, and even just survive, in a tight economy and increasingly competitive health care market.
“Economists have studied whether non-profits behave differently than for-profits. Do they provide more charity care [free or discounted medical services for poor patients]? Do they invest more in community well-being? The answer generally has been no,” Rosenthal said.
One study, conducted in 2020 by Joseph Bruch, PhD ‘21 and David Bellamy, PhD ’23, indeed found no significant difference between what non-profit and for-profit hospitals spend on charity care as a percent of their total expenses.
“It’s getting harder and harder to tell the difference between a non-profit and for-profit board of directors,” McDonough said. “It’s this for-profit ethos that has swarmed and swamped the U.S. medical space. Many people think the system can prioritize patients and profits at the same time and that it will be okay. But then we look at calamities like Steward, and we think to ourselves, maybe it can’t. And maybe it won’t be okay.”
Consequences of cost-cutting
For Steward patients, it wasn’t okay. Reports of poor-quality care and compromised patient safety ran the gamut: from understaffed emergency rooms and ill-equipped maternity wards, to stairwells infested with bats, to cancelled surgeries and suspended trash service due to unpaid invoices. These extreme examples represent what a growing body of research suggests: Health care quality declines when private equity and its extreme for-profit approach take over.
A 2023 study found that Medicare patients at private equity-owned hospitals suffered a 25% increase in hospital-acquired complications compared to Medicare patients at hospitals not owned by private equity. These complications included a 38% increase in bloodstream infections from central lines—longer-term, surgically inserted ports through which patients can intravenously receive fluids, medications, and blood—despite 16% fewer central lines placed. Similarly, the rate of surgical site infections doubled at private equity-owned hospitals while those at the control hospitals decreased. And while falls at hospitals not owned by private equity have been trending downward—a product of a nationwide, decades-long hospital safety movement—falls at private equity-owned hospitals have remained steady, amounting to a 27% relative increase.
“We believe [these findings are] largely explained by staffing cuts,” said the study’s senior author Zirui Song, PhD ’12, associate professor at Harvard Medical School and Massachusetts General Hospital. “The unique financial pressures private equity-owned hospitals face, such as new debt placed on them from the acquisition and expectations of profitability in the short run, may lead to cutting the costs of delivering care—such as through reducing staffing. But while you may be able to substitute people with machines in other industries, health care remains human-labor intensive, especially inpatient care. Cutting staff can have salient consequences for quality of care and patient outcomes.”
Another study by Song and colleagues found that private equity-owned hospitals earned 27% more income after acquisition than hospitals not owned by private equity. That financial gain was fueled by increasing charges—the asking prices for hospital services—by between 7% and 16%, depending on the department, as well as by issuing more charges per day and seeing fewer patients enrolled in Medicare, which provides lower reimbursements than commercial insurers.
A “Save Our Hospital” sign is displayed outside the former Nashoba Valley Medical Center, which was part of the bankrupt Steward Health Care company and closed on Aug. 31, 2024. (Charles Krupa / AP Photo)
Exacerbating disparities
What type of hospitals does private equity tend to target?
New evidence from Song and colleagues suggests that firms typically set their sights on financially healthier—rather than struggling—hospitals, compared to similar peer hospitals that were not acquired. That’s because private equity firms tend to place new debt onto acquired hospitals, and those on stronger financial footing are better able to take on that debt.
There are examples, however, of hospitals serving mostly uninsured or publicly insured patients being taken over by private equity firms. These takeovers may exacerbate health disparities, as many of these disadvantaged patients belong to racial or ethnic minorities and already suffer worse health outcomes, said Song. When discontinuation of hospital services—or total closure—occurs, it has an outsize impact in communities where access to health care is already limited. Carney Hospital is one such example; in an op-ed, Harvard Chan School’s Alecia McGregor, assistant professor of health policy and politics, called its closure “a matter of life and death” that threatens to deepen Boston’s already extreme racial disparities in health.
“I don’t think there is enough evidence to definitively say that private equity targets hospitals that mostly serve people of color. But in some cases, these financially vulnerable facilities may fit their business model,” McGregor said. “And when private equity backed acquisitions lead to closures, this is when marginalized communities often hurt the most. Take Hahnemann University Hospital, for instance—a historic facility serving mostly low-income Black and Hispanic Philadelphians that was closed by its private equity owner after less than two years. Many viewed the closure as a maneuver for the hospital’s prime city real estate.”
PESP also reports that a quarter of private equity-owned hospitals serve rural populations, whose health care alternatives are sparse if they’re unsatisfied with quality or costs and whose outcomes are jeopardized if the only hospital in town closes. Since Nashoba Valley Medical Center was closed, first responders travel around 15 miles to transport patients to emergency care, according to a local fire chief. They used to travel three.
Policy potential
“Theoretically, there could be benefits to private equity investments in health care. They could provide facilities and clinicians with an infusion of capital, but also with managerial know-how and business acumen that might improve health care, such as through making care more ‘efficient,’” Song said. “Unfortunately, however, the current evidence base does not support that. Rather, evidence seems to suggest that by cutting the human labor and other inputs that make care delivery possible—also seen in private equity acquisitions of physician practices and nursing homes—the care might just become less safe.”
Song published a series of policyrecommendations for officials looking to reduce corporate influence, specifically that of private equity, over health care delivery and outcomes. His recommendations for state policy included reviving or enforcing corporate practice of medicine laws, which, in their aim to protect physicians as independent practitioners, can go as far as prohibiting corporations from hiring physicians or influencing medical decisions. His recommendations for federal policy included:
Strengthening fraud and abuse protections
Improving Federal Trade Commission staffing and bandwidth, in order to improve oversight over health care acquisitions and mergers
Discouraging risk-taking behavior by corporate owners (sometimes referred to as moral hazard), through measures like legally affiliating private equity firms with their rolled-up set of acquired entities, limiting the percent debt a firm can use to make an acquisition, and reforming the tax benefit that allows private equity proceeds to be taxed at 20% (rather than the regular corporate business rate, which is higher)
Regulating health care prices and prohibiting surprise billing
Increasing public transparency into private equity acquisitions
Some policymakers have already begun efforts to enact these recommendations. In June, Massachusetts senators Elizabeth Warren and Edward Markey introduced the Corporate Crimes Against Health Care Act, which would penalize private equity firms if a health facility they own closes or has poor finances resulting in injury or death to a patient. A month later, Markey proposed another bill, the Health Over Wealth Act, which would require greater transparency for private equity firms and for-profit companies that own health care entities.
Meanwhile, in the last year, several congressional committees—including the Senate Budget Committee, the Senate Committee on Homeland Security and Governmental Affairs, and the House Committee on Ways & Means—have launched investigations into and held hearings on the role of private equity in health care. On a state level, legislation to regulate private equity in health care is pending in Massachusetts, New Jersey, New York, and Pennsylvania. California, Indiana, Minnesota, New Mexico, and Oregon already have programs that do so. (In September, California Governor Gavin Newsom vetoed a bill that would further intensify regulations.)
Protesters gather in front of the Massachusetts State House to advocate for keeping Nashoba Valley Medical Center and Carney Hospital open. (Steve LeBlanc / AP Photo)
Deeper changes
These regulations—if passed—could help protect physicians as well as patients. One of the significant changes from the corporatization of health care is that, increasingly, physicians are no longer working for themselves. In the 1980s, most doctors owned their own small clinics. Today, nearly 80% are employed by a hospital system or corporation—up from just over 60% in 2019, according to Avalere Health.
“If you’re a physician working in a hospital, chances are you don’t work for the hospital. You work for a corporation,” McDonough said. “And when you sign on with the corporation, you sign a non-compete clause. You can’t criticize anybody or raise your voice even as your workload keeps growing, even when you’re the only physician in the emergency department with multiple traumas, even when you’re seeing patients being put at risk and your colleagues being exploited.”
As this hypothetical proves reality for more and more physicians, many are banding together to advocate for some of the policies Song recommends. A physician advocacy group called Take Medicine Back, for instance, is working to garner support for corporate practice of medicine laws.
Burnt out, frustrated—and organizing
In November, primary care physicians employed by Massachusetts’ largest health system, non-profit Mass General Brigham, cited the “corporatization of medicine” among their reasons for pushing to unionize. Across the country, a small number of doctors—around 70,000, representing 8% of the profession—already belong to a union. But that number has been growing steadily, and will likely continue to do so with the arrival of a new generation of physicians. Currently, 20% of medical residents—more than 32,000—belong to a union, a number that has doubled since 2019.
But tighter regulations on private equity and corporations in health care can only achieve so much. Many experts believe deeper changes to health policy and investments in public health are equally needed. Examples include:
Higher reimbursements for public insurance, so that, in McGregor’s words, “small community hospitals that serve populations largely on Medicare or Medicaid can better meet their costs and remain in business without the private sector filling in”
Simplified health insurance systems, like those in the Netherlands and Switzerland, that use private insurance plans that are streamlined, with fewer choices, making them more transparent and easier to understand and regulate
Funding for non-medical social care, such as housing and food—in Rosenthal’s words, “social supports that make a big difference in people’s lives and that, when underinvested in, drive up our health care costs”
‘One of the biggest lies we’ve ever been told’
These additional policy levers could help diminish for-profit health care’s influence, but by how much is a matter for debate.
“At the end of the day, I think we’re always going to have this kind of mixed public and private system,” Rosenthal said. “Politically, it would be very challenging for us to go in a more government-focused direction. There’s just a lot of distrust. And the one big thing that’s quite different about our country is that we don’t consider health a right. It’s not in our constitution like it is for many of our peers.”
But significant change may be on the horizon, driven by public discontent around health care and growing visibility, brought by cases like Steward, into the consequences of a system where profits can come at the expense of patient care.
When health care follows the money, we get sicker and sicker.
Alecia McGregor, assistant professor of health policy and politics
“As a country, we’ve become desensitized to this notion that health care is the same as any ordinary commodity, and that the provision of health care can be run like any other business,” McGregor said. “I think this is one of the biggest lies we’ve ever been told, because we’ve seen health care costs skyrocket in a way that’s different from any of our wealthy country counterparts, yet our outcomes—life expectancy, maternal health, infant mortality—are abysmal. When health care follows the money, we get sicker and sicker.”
“Surrendering our health care system to the for-profit marketplace was a fundamental error that we’re paying the debts of right now,” McDonough added. “But I see people working on it, reassessing the role and value of for-profits and asking what a post-neoliberal health care system might look like.”
In the meantime, the story of Steward, now under new ownership and a new name, continues to unfold. Its physician network, made up of 5,000 doctors, was recently purchased by Rural Healthcare Group and rebranded as Revere Medical. Rural Healthcare Group is owned Kinderhook Industries, a private equity firm.
For concerned patients, Rosenthal offered some concrete advice. “Find a provider you trust and be skeptical. Always ask about the benefits of an intervention. Because more services, more tests, more treatments are not always beneficial—but they’re always profitable.”
