Adding Private Equity's "skim" to your anesthesiology bill

… This is the 2023 version of “When Mitt Romney came to town”.

{{The Federal Trade Commission, which is supposed to prevent unfair business practices, questioned the company’s growth but did not stop it.

The company raised prices for its services — one by nearly 30 percent in its first year in Colorado — and continued raising them for several years, according to interviews and confidential company documents obtained by The Washington Post. The price hikes boosted patient bills and pushed up insurance rates, former company physicians and managers said. Eventually, some of the company’s own doctors became disillusioned, physicians said, with about 1 in 3 leaving the company over a three-year period.}}



I asked a nurse at my doctor’s office if an insurer owned the practice. Sure enough Optum insurance owns the business. I asked the nurse how she saw it good or bad? She said, “only speaking for myself, not so much”.

I am not happy about it. There is no choice. Yeah I can go to another group but it will be another insurer. Also I go to specialists and those folks are under other insurers.


Yep. Optum…the very company I mentioned as taking over primary care practices in these parts a while back. I think it was a thread on corporate entities and speciality groups in hospital settings (like these anaesthiology groups) started by @intercst but in a general sense, more folk are likely to be affected at primary care level.

My daughter’s attitude when I suggested she switch from her Optum owned PCP to ours was “Why bother”…expecting more of the same/imagining there was no choice. Once she did, she saw the difference. For now. Not feeling fireproof, me.

Edit:…ooops, sorry @WendyBG. I gotz it 'rong. Your thread start AND on the topic of corporate take over of primary care practices (it’s apparently one of my quasi OCD double-checking days today…I had to check)


AA was better than nothing but still sucked as a strategy to amend past and present racism by both institutions and individuals, whether still maintained through inertia from the past, indoctrination, stupidity, or active malevolence,

Actually solving our race and poverty problems would require a return to the original brilliant strategy of excellent public eduation for all with funding set at world beating levels while also vastly improving pre-natal and pre-school programs. And it would not hurt to become far far far more welling to toss aside our addiction to the obsolete “finishing school for young gentlemen” model of our 4 year college education system and move to far more flexible systems by using on-line, AI assisted, independently accredited methods.

The rewards would be immense. Finland, despite having almost zero advantages in resources other than pine tar and fish, now, after 4 generations of an infant care and Eduacation First strategy, has a world beating economy, stunningly lower costs due to criminality and countering criminality, is world beating in ending homelessness, and is becoming a leader in successful assimilation of refugees from around the world.

No mysteries. The Finns correctly see their children as their primary resource and have public policies that are consistent with that vision. We are tangled up in idiotic mostly obsolete and superstition based conflicts and strategies.

david fb


As it happens, this is a common topic of discussion at casa VeeEnn. Not so much due to the financials as the practical impact on patient care. Was able to ask dh about this exact thing today.

Prior to our move to the Wild West (and allegedly full retirement) dh had come from Harvard and prior to that Cornell so the big presence of specialty practice groups…corporate owned or otherwise…was something new. My own hospital based experience dates back decades to the UK where everyone was employed by the hospital so I have a hard time wrapping my head around how having whole services manned by, say, “jobbing anaesthesiologists” as described here. I’m forever asking dh “well, how does that work…” Sometimes it apparently doesn’t.

So, at his gig, anesthesiology services are supplied by a company (don’t know if it’s this one) and, unlike in Days of Yore, no one knows who’s going to turn up until they do. If they do. Thursdays are dh’s procedure mornings and he usually knows the theoretical start time and the scheduled cases the night before (emergencies excepted) This last Thursday the gas man didn’t show for an 8.30 start. 10 o clock still no one. After numerous phone calls the whole morning’s procedures had to be canceled. Can you imagine if that were you or a family member. I’m thinking primarily about the patient (because it could be me) but who could handle a career structure like this if that’s the norm? Not I.


This also presents a problem for the patient. If I don’t know which “gas man” is showing up, how do I tell if he’s “in-network” in my insurance plan? I’m jumping off the table and going home if I don’t have written confirmation that everyone working on me is “in network”.

With traditional Medicare, the tables are reversed. If a provider doesn’t provide you with advance written notification that they don’t accept the Medicare reimbursement, they can’t bill you for any extra.



In relative terms we have denied our economic might for 40 years. We took one for the team capitalism in the west. We scrambled all of us to stay afloat. We took resources and denied others resources. We reverted to harming African Americans. That is in our DNA as a nation. Does not matter if you just arrived here as an immigrant that is what you are doing. Does not matter if you believe prejudice stereo types that is what you are doing. You are climbing over black bodies to get yours.

We are going back to demand side econ and economies of scale. We can afford to give to all American citizens. We have to give to all. As for the silly boomers just stop the stupid.

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