Wealth-based health-care rationing is bad enough, but when it's combined with the public purse, a bad system becomes a *nightmare*. Take hospice care: private equity funds have rolled up huge numbers of hospices across the USA and turned them into rigged - and lethal - games:
https://pluralistic.net/2023/04/26/death-panels/#what-the-heck-is-going-on-with-CMS
Medicare will pay a hospice $203-$1,462 to care for a dying person, amounting to $22.4b/year in public funds transfered to the private sector.
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Incentives matter: the less a hospice does for their patients, the more profits they reap. And the private hospice system is administered with the lightest of touches: at the $203/day level, a private hospice has *no* mandatory duties to their patients.
You can set up a California hospice for the price of a $3,000 filing fee (which is mostly optional, since it's never checked).
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You will have a facility inspection, but don't worry, there's no followup to make sure you remediate any failing elements. And no one at the Centers for Medicare & Medicaid Services tracks complaints.
So PE-owned hospices pressure largely healthy people to go into "hospice care" - from home. Then they do *nothing* for them, including continuing whatever medical care they were depending on.
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