For Lauren and Lilian, two Cambridge residents, a recent trip to the doctor felt less like a medical consultation and more like an assembly line. “It feels like they are trying to get the appointment over quickly,” they said in a conversation on the lawn of the Cambridge Main Library. “There’s no room for questions … we sort of have to force them in.”
Their experience is far from isolated. Health care is a universal public utility, but Wall Street financing models threaten our local independent care systems. As a Cambridge eighth grader, I have been investigating and researching the impact of health care corporatization – the growing treatment of hospitals as businesses, often prioritizing profit over patient care – and what this means to our communities and families here. My research has shown a fascinating conflict: I interviewed a Harvard researcher who argued corporate health care increases patient mortality, while the chief executive of the Cambridge Health Alliance says corporate health care is the only way to keep doors open.
This leaves residents in an interesting position, as facilities are forced to corporatize to survive even though research shows it can degrade patient care.
During my interviews with professors at the Harvard T.H. Chan School of Public Health, many professors shared their perspectives of treating health care as a financial asset. “Health care doesn’t operate like other markets. There are more opportunities for transaction and retraction,” one said.
Dr. Joseph Bruch, a Harvard alumnus and now assistant professor of public health at the University of Chicago, links this to “profit domination becoming the interest.” Dr. Ben Sommers at T.H. Chan, interprets the effects of corporatization through the lens of impact on our most vulnerable populations. As private equity continues to buy up independent medical practices, we encounter “risks of changing care that doesn’t help patients and is more focused on profit.”
On the executive side, CHA chief executive Dr. Assaad Sayah, a cardiothoracic surgeon, said, “Growing corporatization is a response to financial challenges … We must think like a business, especially during difficult times.”
Professors and researchers argue we risk prioritizing profit over patient care, while executives such as Sayah say hospitals must rely on corporatization to keep the doors open.
If hospitals are treated as businesses, does that make patients into sources of profit rather than people? Are doctors cogs in the machine?
Rachel, a health care worker for six years, has seen the mechanics of this shift from the inside. “Specialists have long waits. It’s taken me six to nine months to get an appointment,” she said. She attributes this to corporate quotas driven by insurer profit margins: “They have a certain quota of appointments to meet … This makes some people feel like they aren’t getting the attention they deserve.”
The dangers of treating health care as a financial asset are not hypothetical. They are playing out destructively across Massachusetts as private equity firms follow a playbook: acquiring financially vulnerable facilities, stripping their assets and leaving patients to bear the consequences.
An example of this is visible in the trajectory of Genesis HealthCare, a nursing home chain operating dozens of facilities across New England. When Genesis faced severe financial strain, it fell into bankruptcy court, where it tried and failed at an insider sale through a secret auction. After a takeover by ReGen Healthcare, a private equity company, impact on patient care became undeniable. Lawmakers tracking the transition noted that the proportion of Genesis facilities earning above-average federal quality ratings plummeted to just 15 percent from 38 percent, while their average rating dropped significantly on the federal five-star scale. In a series of reports for The Boston Globe, journalist Kay Lazar revealed that the company’s closed-door auction was able to clear out legal claims brought by families who accused the facilities of severe medical neglect and wrongful death.
Jonathan Saltzman, an investigative reporter for The Boston Globe, said in an interview that “the state does not do an aggressive enough job regulating increased concentration of power among big corporations. More power is concentrated in fewer hands. For example, many patients and doctors alike agree the economic power of Mass General Hospital is far too powerful.” This introduces a dangerous imbalance into our local medical infrastructure. The core risk remains identical: When health care power is consolidated into corporate hands, clinical quality is sacrificed for financial leverage.
Eden Abay
Putnam Avenue
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