Business Cycles; Death of a Hospital

 #Charles Duhigg, "Cool Story, Bro," The New Yorker, June 7, 2021. - "Economics is a science of cycles. There is the business cycle and the inflationary cycle, the rhythms of housing booms and credit busts." "John Maynard Keynes wrote that the marketplace is frequently guided by 'animal spirits' that 'depend on spontaneous optimism rather than a mathematical expectation.' " "Financial affairs have an 'instability due to the characteristic of human nature.' "

"After the First World War, a group of speculators promised easy stock-market profits through a new fad: the mutual fund. Today, the mutual funds are among the safest and most popular investments." "Jeff Epstein, an operating partner at Bessemer Venture Partners, who runs a SPAC of his own, said, 'We've just lived through one of the greatest wealth-accumulation periods in history, and a lot of the public has been blocked from participating."  Virgin Galactic, which proposed to send customers into space for a substantial payment, forecast 2020 revenues of thirty-one million dollars, but the company had collected only two hundred and thirty-eight thousand dollars. "It is still unclear when, if ever, it will send customers into space."

"If an everyday investor had brought one share of stock in each of his SPACs on the first day the stock traded, three of those investments would have lost money. Many other SPACs have done much worse. Some public shareholders lured by impossibly rosy financial protections, have lost enormous amounts of money investing in companies that otherwise would likely have never been sold to the public."

#Chris Pomorski, "Death of a Hospital," The New Yorker, June 7, 2021. - "Philadelphia is one of the poorest big cities in the United States, with about a quarter of its 1.6 million residents living below the poverty line." "Hospitals in the U.S. are estimated to be closing at a rate of about thirty a year. Most closures happen for financial reasons, in places where there are relatively few privately insured patients. Increasingly, hospitals are regarded as businesses like any others: at least a fifth of hospitals are now run for profit."

"In the decades after the Second World War, the cost of hospital care rose significantly, spurred by expensive procedures, and by the adoption of medical insurance." "Medicare and Medicaid, which account for more than sixty per cent of all U.S. hospital care, often pay less than the cost of treatment: according to an analysis by the American Hospital Association. In 2018, Medicare and Medicaid underpaid the cost of care by a combined $76.6 billion." 

"The nurse-consultants sometimes second-guessed the diagnoses of residents. 'They were thinking about the bottom line, and we were just thinking about the patients,' Christy Johnson, a former resident said." 

"Since 2008, American hospitals have been involved in more than a thousand mergers and acquisitions, resulting in large, powerful health systems with influence on the price of hospital care and the reimbursement rates paid by private insurers."

The Hahnemann University Hospital in Philadelphia, along with another medical center, St. Christopher's Hospital for Children, for a hundred and seventy million dollars, by American Academic Health System, a company controlled by the California private-equity firm Paladin Healthcare Capital. Joel Freedman, the founder and C.E.O. of Paladin, had managed a sizeable hospital in Washington, D.C., and a few smaller ones in Los Angeles.

In early April, the Hahnemann University Hospital foretold the demise of Hahnemann by laying off a hundred and seventy-five employees, including sixty-five nurses. Eileen Appelbaum, a co-director of the Center for Economic and Policy Research, a progressive think tank, told the article's author that Hahnemann's demise reminded her of the retail sector, where hedge funds and private equity have used leveraged buyouts to purchase chains like Sears and Toys R Us, and then stripped their assets, including  real estate, on a route to bankruptcies. "Patients were released without clear follow-up care and often ended up back in the E.R. within twelve hours."

The story of Hahnemann is as much about the structural forces that have compromised many American hospitals -- stingy public investment, weak regulation, and a blind belief in the wisdom of the market -- as it is about the motives of private-equity firms."

#Shreya Chattopadhyay, "By the Numbers," The Nation, 6 . 14 - 21 . 2021. 

$236B - Total US military aid to Israel from 1946 to 2018.

$38B - US military aid pledged to Israel from 2019 to 2028.

0 - Number of countries set to receive more US military aid than Israel between 2019 and 2028.

59% - Share of US foreign military aid in 2021 set to go to Israel.

50 - Number of F-35 Joint Strike Fighters, the US's most advanced stealth aircraft, purchased by Israel from Lockheed Martin with US funds.

51:1 - Ratio of US military aid received by Israel to US humanitarian assistance received by Palestinians in 2021.

1 - Number of countries that are allowed to use US military aid for their own domestic weapons industry.