Key Billionaires and Their Healthcare Holdings

Several billionaires with influential political ties control these powerful firms. Stephen Schwarzman, with a net worth of $55.6 billion and the CEO of Blackstone, Inc., owns major healthcare firms like TeamHealth. Henry Kravis ($6.5 billion) and George Roberts ($12.2 billion), the founders of KKR, are heavily involved in acquisitions such as Envision Healthcare. David Rubenstein ($4 billion), the co-founder of The Carlyle Group, is known for investments in healthcare, including ManorCare nursing homes. Bill Gates ($106.6 billion) also has a significant presence through his foundation and healthcare investments. Warren Buffett ($148.3 billion), through Berkshire Hathaway, is a major investor in healthcare-related stocks.

The financialization of healthcare began in the early 2000s, with private equity firms targeting healthcare sectors like physician practices, hospitals, and nursing homes. They saw these as stable and profitable investments due to consistent demand and third-party reimbursements. In the first decade of the 21st century, private equity firms started acquiring smaller healthcare entities through leveraged buyouts. By the 2010s, investments in healthcare surged, with deals growing from $5 billion annually in 2000 to over $100 billion by 2018. Sectors like urgent care, primary care, and specialty practices became prime targets.

The Impact of the COVID-19 Pandemic

The COVID-19 pandemic further accelerated the trend. Healthcare providers faced financial strain, and private equity firms acquired distressed practices and hospitals. They consolidated market power while implementing aggressive cost-cutting measures. By 2023, private equity firms had spent $505 billion on healthcare acquisitions over five years, extracting profits through increased fees, reduced staffing, and operational consolidation.

Study on Nursing Homes

A 2021 study published in Health Affairs analyzed the impact of private equity ownership on nursing homes. It found that facilities acquired by private equity firms, like Blackstone and The Carlyle Group, experienced a decline in patient care quality and a 10 percent increase in mortality rates. These outcomes were attributed to reduced staffing, cuts in essential supplies, increased patient-to-staff ratios, and cost-cutting measures aimed at maximizing profits.

Acquisitions in Behavioral Health

Acquisitions in behavioral health have also led to increased costs for patients and cuts in essential services. Private equity now owns approximately 7 percent of addiction treatment facilities and over 6 percent of mental health clinics in the US. Essential but less profitable services, such as community-based mental health programs and addiction treatment, have been scaled back or discontinued.

The Broader Implications

The consolidation of healthcare into fewer, larger corporate entities by private equity gives finance capital unprecedented control over public health. This commodification undermines access to affordable care while enriching a narrow layer of investors. The restructuring of healthcare is not just a technical issue but a political one that requires organized action from workers to pursue public healthcare systems that prioritize human need over profit.

Political Ties and Influence

Both big business parties in the US are complicit in this process. Donald Trump appointed Robert F. Kennedy Jr., an anti-vaccine advocate, as Secretary of Health and Human Services. Other healthcare posts went to similar open enemies of public health. There is a clear intersection between the financialization of healthcare and politics, with the dismantling of public health infrastructure supported by both parties.

Blackstone has significant influence in both finance and politics. Schwarzman, a prominent Republican donor, has close relationships with politicians like Donald Trump and advised on financial policy during the Trump administration. Blackstone's investments in real estate and healthcare have been shaped by deregulation efforts supported by these political ties.

Apollo Global Management maintains deep ties with politicians, hiring former Republican Senator Pat Toomey and Harry Reid's Chief of Staff David Krone. These connections strengthen its position in healthcare, real estate, and finance sectors, facilitating corporate influence over public welfare.

KKR's Henry Kravis, a significant Republican donor, has advocated for policies that benefit private equity, including tax structures favoring carried interest.

The Military Sector Connection

The Carlyle Group, known for its close ties to Washington D.C., has employed former politicians like former President George H.W. Bush and former Secretary of Defense Frank Carlucci as advisers or partners. These connections have helped Carlyle secure lucrative defense contracts and investments in regulated industries.

The Role of Unions

In the context of the growing class struggle and healthcare industry strikes, the role of unions must be scrutinized. Unions have often facilitated the process of consolidation and cost-cutting measures under the guise of job security. For example, the Service Employees International Union (SEIU) has partnered with healthcare corporations to enforce “labor–management partnerships” that endorse cost-saving measures at the expense of workers.

During the COVID-19 pandemic, HCA Healthcare proposed wage and benefit cuts, and the SEIU facilitated the concessions. In some cases, the SEIU has supported the privatization or consolidation of public hospitals, arguing that it would protect jobs. The National Union of Healthcare Workers (NUHW) has agreed to contracts with minimal wage increases and failed to address understaffing issues.

The American Federation of State, County and Municipal Employees (AFSCME) has negotiated contracts with wage freezes and benefit reductions. The California Nurses Association/National Nurses United (CNA/NNU) is also known for collaborating with management, especially at Kaiser Permanente.

Union agreements have prioritized the financial viability of employers over the needs of workers, endorsing wage freezes, benefit cuts, and increased workloads. They have supported mergers, creating false illusions of job security through economies of scale while often leading to layoffs and the erosion of working conditions.

The defense of public health requires a fight against the union apparatus. Rank-and-file committees must be built to transfer power to healthcare workers and link up struggles across the world in a common fight against the financialization of the industry. Healthcare must be defended as a basic social right available to all based on need.

For the working class, gaining control of public health is a matter of life and death, as demonstrated by the COVID-19 pandemic. We need to remove the restraints imposed by the profit system and reorganize social healthcare on a scientific, rational, and humane basis.