Above: "The Farmer's Kitchen," an oil painting by Ivan Albright (1897-1983), created while he was in the New Deal's Public Works of Art Project, 1933-1934. Image from the Smithsonian American Art Museum.
How the 1% profits from the neglect and abuse of elderly and dying Americans
The greed of the 1% knows no bounds, and we can clearly see that in its increasing involvement in hospice and nursing homes. Their business model is essentially: take it over, reduce services and staff, and pocket the difference. And in the wake of that sociopathic business model is the neglect and abuse of our elderly.
With respect to hospice...
Dr. Ira Byock, a physician and palliative care expert, who describes himself as "an American and a capitalist," explains: "When the for-profits began in the mid-to-late 1990s, I was actually a champion for them... in the early 2000s, some of the very best for-profit programs went through initial public offerings and became publicly traded. After that we watched the hospice quality spiral down and the attitudes of the new management focus on finances...
"Today I fear we're seeing the death knell of hospice in America... Many of the for-profits maintain their high profit margins by skimping on services, tolerating unmet need among the dying patients they serve, shifting costs to families, short staffing on nurses, maintaining unreasonably high caseloads, and short staffing doctors. We're watching doctors go away from hospice care. It's such a cruel irony to know that in the beginning we created hospice in part to ensure dying patients had access to physicians. Now a number of hospice programs have themselves become the barriers to dying patients being able to access their doctors" ("Medicare Hospice – Exploding in Size But Riddled with Quality Concerns," University of Pennsylvania, Leonard Davis Institute of Health Economics, March 8, 2024).
With respect to nursing homes...
"As private equity investment in nursing homes continues to soar, studies showing higher mortality rates and lower quality of care in private equity-owned nursing homes have renewed concerns that the tens of billions of taxpayer dollars spent each year on nursing care may, in fact, be lining the pockets of rich private equity investors at the expense of vulnerable seniors" (Melea Atkins, "The Impact of Private Equity on Nursing Home Care: Recommendations for Policymakers," Roosevelt Institute, April 2021).
"Private equity firms have become a growing presence in the nursing home industry, bringing troubling trends in fines and care quality. Research links private equity ownership to understaffing, higher fines, and increased risks of nursing home abuse and neglect" ("Private Equity Ownership Linked to Rising Nursing Home Fines," Nursing Home Abuse Center, January 23, 2025).
Strangling public funds...
Alongside the 1%'s increasing and malevolent involvement in hospice and nursing homes, is the 1%'s control of government, and the 1% have used that control to give themselves repeated tax breaks; and these tax breaks have starved government of revenue - revenue that could be used for, among other things, better-funded and better-staffed hospice programs and nursing homes. The 1% have also demanded, and received, cuts to the nation's social safety net, for example, Medicaid. They are also, of course, always looking to gut Medicare and Social Security in an effort to ward off any future revenue requests, such as raising the Social Security contribution cap.
The results of underfunding and understaffing, caused by the greed of the 1%...
Underfunded and understaffed nursing homes lead to chronic neglect and higher rates of abuse:
"Current internal structures such as poor patient-staff ratios, poor staff credentials, and staff burnout contribute to the prevalence of abuse and neglect against elderly patients... Care facilities such as nursing homes have the highest reported rates of abuse, with 2 in 3 staff reporting some form of abuse in the past year. Across nine studies conducted in 2019, 64.2% of staff admitted to some form of elder abuse in the past year. Similarly, in a national survey of nursing home staff, 40% admitted to psychologically abusing their patients" (Erica Bassett, "Abuse and Neglect against Elderly Adults in Nursing Homes in the United States," Ballard Brief, Marriott School of Business, Brigham Young University, Spring 2021).
Mass apathy...
That the 1% don't care about our parents, grandparents, and great-grandparents who need hospice services or reside in nursing homes, is no surprise. After all, this is the same crowd that invests in mass incarceration, global warming, diabetes-causing "food," cancerous cigarette smoking, disease prolongation (long-term symptom management is much more profitable than curing a disease), and missiles and bombs to obliterate people in one needless conflict after another.
But why do so many of the rest of us tolerate it? Especially when it's our tax dollars (e.g., payroll taxes that fund Medicare and sales taxes that fund Medicaid) that the 1% are cashing in on? I suspect it's due to so much apathy-causing and attention-grabbing distraction, for example, culture wars, celebrity worship, and endless TV shows on endless channels and streaming services. Also, our obsession with work. The 1% have us brainwashed into thinking that work is the most important thing in life--which is a very convenient brainwashing since it builds their fortunes and facilitates their luxury--even more important than spending time with family, enjoying the world around us, and (of course) fighting back against the abuses of the 1%.
A better way...
If we're ever brave and attentive enough to fight back against our 1% bullies, we can draw inspiration from FDR's Economic Bill of Rights, where he advocated for the right to "adequate medical care," "good health," and "adequate protection from the economic fears of old age." We can also draw inspiration from the General Welfare clause of the Constitution, a clause that the 1% would no doubt like to see removed from that founding document.
But will we fight back? That's really the key question.
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