Wilful ignorance is unpardonable in anyone, especially those responsible for policy-making, but that is exactly what is happening in healthcare. The business media’s staple diet everyday is valuations, return on investment and so on, with no attempt to look beyond financial and investment metrics to quality of patient care. Taking care of your health has never been more critical than ever before for a simple reason: you just can’t afford to fall sick.
Wilful ignorance is unpardonable in anyone, especially those responsible for policy-making, but that is exactly what is happening in healthcare. The business media’s staple diet everyday is valuations, return on investment and so on, with no attempt to look beyond financial and investment metrics to quality of patient care. Taking care of your health has never been more critical than ever before for a simple reason: you just can’t afford to fall sick.
Ideals are often proclaimed, seldom followed.
This is what The National Health Policy, 2017 states: “The primary aim of the National Health Policy, 2017, is to inform, clarify, strengthen and prioritize the role of the Government in shaping health systems in all its dimensions- investments in health, organization of healthcare services, prevention of diseases and promotion of good health through cross sectoral actions, access to technologies, developing human resources, encouraging medical pluralism, building knowledge base, developing better financial protection strategies, strengthening regulation and health assurance”.
The ground reality is shaping up in the opposite direction. We must first note Mumbai Mirror’s outstanding journalism over the last two-three covering the state of affairs in JJ Hospital ST George’s Hospital, VN Desai Hospital. On September 18, 2025, Mumbai Mirror ran a story ‘Think JJ hostel is bad? Take a look at St George’. A frightening story was on August 18, 2025 ‘Fake doctor scandal at VN Desai triggers blame game between BMC and contractor’. Not assuring at all.
Contrary to the 2017 Policy’s statement, instead of public health enlarging its area of coverage, we find a phenomenon in healthcare that we are already seeing in education: the retreat of the government. This vacating has opened up the space for private players to enter and since, in India, everything has become a matter of scale, private equity (PE) has entered in a big way.
Selective narrative
This is The Economic Times on August 23, 2025: ‘Global PE firms tighten grip on India’s $80-billion hospital sector’
ET’s story is based on a report by Grant Thornton and industry data. Singapore’s Temasek, and US-based TPG and KKR, have led large acquisitions including Manipal and Max Healthcare. Other global players such as CVC Capital, General Atlantic, TPG Growth, BPEA EQT, and Advent International have also built significant stakes across India’s leading chains, according to Grant Thornton and industry data, as accessed by TOI. As the ET story says, “Blackstone owns 80% in KIMS Kerala and 73% in Care Hospitals, Temasek holds 59% in Manipal Hospitals, while Arpwood Partners and OTPP have taken full ownership of Sterling and Sahyadri Hospitals”. ET adds that this shift in India mirrors a similar phenomenon in the US. However, it does not even mention what has been the experience of patients in the US after the entry of PE in healthcare.
This article tells that story, which every Indian patient must read. So should policy makers.
The other side of the story
In an article titled, ‘What Happens When Private Equity Takes Over a Hospital’ (December 2023), Jake Miller, says, based on a research, published Dec. 26 in JAMA, by Harvard Medical School, that “Patients are more likely to fall, get new infections, or experience other forms of harm during their stay in a hospital after it is acquired by a private equity firm”. Among the few nation-wide such efforts, this research has focused on “conditions or outcomes deemed preventable and are key measures of hospital safety and quality”. There is concern because of PE’s increasing role in U.S. health care, with $1 trillion invested in the past decade.
The study is what statisticians will characterise as statistically significant, because it “examined insurance claims data for all fee-for-service Medicare hospitalizations from 2009 to 2019, totaling more than 600,000 hospitalizations at 51 private equity hospitals and more than 4 million hospitalizations at 259 similar hospitals not acquired by private equity. The hospitals not acquired by private equity served as the control group to control for other factors that may have affected outcomes”.
Naturally, according to supporters of the entry of PE in health care, quality and efficiency will be enhanced by prioritizing investments in rapidly growing sectors, a claim that is not borne out by patient experience at all. On the contrary, PE has increased costs for patients and worsened health outcomes. Worse, there have been closures of public facilities among communities that have always struggled over access to quality healthcare.
The phenomenon is here too. According to media reports, (August 11, 2025), BMC is closing its facilities and opting for privatisation, despite warnings from public health experts. Another article in April observed that ‘Mumbai’s move to privatise five government hospitals will hit slum dwellers hard’.
Pointing to ‘The rising danger of private equity in healthcare’ Judith Garber, a Senior Policy Analyst at the Lown Institute (January, 2024), asks: What could be behind these higher rates of adverse events after PE acquisition? She finds the answer in a Washington Post op-ed, by Dr. Ashish Jha, Dean of the School of Public Health at Brown University, who says that it’s down to two things: staffing levels and adherence to patient safety protocols. “Both cost money, and it is not a stretch to connect cuts in staffing and a reduced focus on patient safety with an increased risk of harm for patients”. Read: The rising danger of PE in healthcare.
Bi-Partisan Senate Committee Report
A bi-partisan report is a rarity these days and hence the Senate Budget Committee Staff Report , January 2025, tellingly titled ‘Profits over Patients’, acquires a tremendous importance. The full report can be accessed here, released through a Press Release on July 1, 2025, by Sens. Chuck Grassley (R-Iowa) and Sheldon Whitehouse (D-R.I.), in their respective capacities as Ranking Member and Chairman of the Senate Budget Committee during the 118th Congress.
Mincing no words, it announced in its headline: Private Equity in Health Care Shown to Harm Patients, Degrade Care and Drive Hospital Closures. You can’t be clearer than that. Given the indisputable criticality of this phenomenon, let us read what the Press Release says: “The Committee focused on two private equity firms—including the single-largest private equity investor in health care—that currently or previously invested in two prominent hospital operators. Throughout the course of its investigation, the Committee reviewed more than one million pages of documents from Leonard Green & Partners, Prospect Medical Holdings, Medical Properties Trust, Apollo Global Management (Apollo), Lifepoint Health and Ottumwa Regional Health Center, a for-profit Iowa hospital, that revealed new information about the business dealings of private equity-owned hospital operators. Documents obtained by the Committee detailed how private equity’s ownership of hospitals earned investors millions, while patients suffered and hospitals experienced health and safety violations, understaffing, reduced quality of patient care and closures”.
Unfortunately, lured by what PE players have achieved in pure financial terms and at the cost of quality of patient care, even Non-profit Health Care is embracing similar investment-oriented approach. In an essay titled Private Equity Strategies in Nonprofit Health Care published by the Policy Forum of the American Medical Association in the Journal of Ethics, Zachary J. Gallin and Emily L. Xu, MD, lament that “Private equity firms exacerbate health inequity by driving hospital closures in historically underserved communities. Now nonprofit health systems seem to be adopting private equity practices to do the same”.
Lies and more lies
In the euphoria in India over valuations and foreign investment and how India is striding on the global space, everything is seen through the prism of business, be it soaps, shampoos, education or healthcare, completely indifferent to the human cost of such unwelcome initiatives. Commenting on the phenomenon of PE in healthcare in the US, Alecia McGregor, Assistant Professor of Health Policy and Politics, Harvard School of Public Health, comes straight to the point. “As a country, we’ve become desensitized to this notion that health care is the same as any ordinary commodity, and that the provision of health care can be run like any other business. I think this is one of the biggest lies we’ve ever been told, because we’ve seen health care costs skyrocket in a way that’s different from any of our wealthy country counterparts, yet our outcomes—life expectancy, maternal health, infant mortality—are abysmal. When health care follows the money, we get sicker and sicker.” And yet, we are going the same way.
She was quoted in an article in December 2024 ‘Private equity’s appetite for hospitals may put patients at risk’ by Maya Brownstein, Media Relations Manager in the Office of Communications at Harvard School of Public Health. In a brilliant start to the article, Brownstein captures all that is wrong with PE in healthcare. “Throughout 2024, eye-opening news headlines from around the country trained a spotlight on the collapse of Steward Health Care:
As Steward hospitals teeter, CEO’s $40 million yacht is docked in the Galapagos Islands
Sick patients collapsed waiting for care in overwhelmed Steward hospital’s emergency department
Steward Health Care files for Chapter 11 bankruptcy”. Read: PE appetite for hospitals may put patients at risk.
Are we still going to insist on compromising patient care to cater to PE’s hunger for profitability?
