Published: April 12, 2022

By Laura Katz Olson (MPolSci'72; PhD'74)  Ethically Challenged

(Johns Hopkins University Press, 425 pages; 2022)

Buy the Book  

Revealing the dark truth about the impact of predatory private equity firms on American health care.

Private equity (PE) firms pervade all aspects of our modern lives. Unlike other corporations, which generally manufacture products or provide services, they leverage considerable debt and other people's money to buy and sell businesses with the sole aim of earning supersized profits in the shortest time possible. With a voracious appetite and trillions of dollars at its disposal, the private equity industry is now buying everything from your opioid treatment center to that helicopter that helps swoop you up from a car crash site. It may even control how and when you can get your kidney dialysis. 

In Ethically Challenged, Laura Katz Olson describes how PE firms are gobbling up physician and dental practices; home care and hospice agencies; substance abuse, eating disorder, and autism services; urgent care facilities; and emergency medical transportation. With a sharp eye on cost and quality of care, Olson investigates the PE industry's impact on these essential services. She explains how PE firms pile up massive debt on their investment targets and how they bleed these enterprises with assorted fees and dividends for themselves. Throughout, she argues that public pension funds, which provide the preponderance of equity for PE buyouts, tend to ignore the pesky fact that their money may be undermining the very health care system their workers and retirees rely on.

Weaving together insights from interviews with business owners and experts, newspaper articles, purchased data sets, and industry publications, Olson offers a unique perspective and appreciation of the significance of PE investments in health care. The first book to comprehensively address private equity and health care, Ethically Challenged raises the curtain on an industry notorious for its secrecy, exposing the nefarious side of its maneuvers.