The Young Turks - Capitalist Crooks

Episode Date: July 13, 2023

Tax prep sites gave millions of taxpayers’ info to Facebook and Google. Once hailed for decriminalizing drugs, Portugal is now having doubts. Private equity bought up Colorado anesthesiology practices, then raised prices. Climate shocks are making parts of America uninsurable. It just got worse. HOST: Ana Kasparian (@AnaKasparian) SUBSCRIBE on YOUTUBE: ☞ https://www.youtube.com/user/theyoungturks FACEBOOK: ☞ https://www.facebook.com/theyoungturks TWITTER: ☞ https://www.twitter.com/theyoungturks INSTAGRAM: ☞ https://www.instagram.com/theyoungturks TIKTOK: ☞ https://www.tiktok.com/@theyoungturks 👕 Merch: https://shoptyt.com Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

You're listening to The Young Turks, the online news show. Make sure to follow and rate our show with not one, not two, not three, not four, but five stars. You're awesome. Thank you. I think it might be a bumpy show, the word decriminalization and anesthesia will come up a lot in the first hour and I'm going to have to say it multiple times and that could trip me up. But it's going to be a great show and you do not want to miss it. In the first hour today, we're going to talk about how private equity firms are snatching up anesthesiology groups and jacking up prices for patients all across the country. There's one state in particular where this practice is particularly pronounced and is hurting

people in that state. So don't miss that story. We're also going to revisit Portugal's decriminalization efforts in regard to all drugs. There are some new statistics out that are troubling, but we shouldn't throw the baby out with the bathwater. I think that there are some promising developments in the works in regard to drug policy in places like Portugal as well. So we'll talk about that. In the second hour, we'll talk about how Fox News is facing yet another defamation lawsuit, this time from a Trump supporter, or at least a former Trump supporter named Ray Epps, who the right wing spread all sorts of insane conspiracy theories about. And we'll also talk about Iowa being the latest state to effectively ban abortion.

So John will join me in the second hour to talk about a whole host of news stories, including that Ray Epps defamation lawsuit. So stay tuned for that. For now, though, just want to encourage you guys to like and share the stream. If you want to support our show, it's the easiest way to do it. You can also become a member and support us that way by going to t.yt.com slash join or just click on or smash. that join button if you're watching us on YouTube. Without further ado, let's get to our first story. The financial data of tens of millions of Americans who file their taxes through online

sites are being sold to third parties like Facebook and Google. That's the outcome of a new congressional investigation spearheaded by Senator Elizabeth Warren. Now making matters worse, the practice has been going on for a long time. time. In fact, dating back to 2011. And this follows a separate report that came out just last year regarding how tech journalism websites, the markup and the verge, were sharing their reader's data with Facebook. So let's get into the findings of the latest report and other details. First, it's worth knowing just how many Americans use these online tax preparation services every year.

H&R Block said it's do-it-yourself tax filing website, filed 8.4 million returns in the most recent tax filing season. An analysis of IRS data by tax prep company column tax found that Tax Slayer filed 1.5 million returns and Tax Act filed 3 million returns for customers in 2022. Now, in order to track the information that users were inputting into their tax prep websites and software, these three companies use something known as pixels. And look, if you're not familiar with the technology, don't worry, neither was I. Just know that it's widely used on websites for ad targeting on social media.

In fact, according to the Washington Post, both Google and Meta, the parent company under which Facebook falls, offer this tracking technology to website admin. administrators. But it's not just about how these websites collected their clients' personal information. The real concern is what they collected and later sold to both Google and Facebook. When users typed their information into the tax forms, the report says, pixel technology sent that data to Google and Facebook, including users' approximate annual gross income, the amount of money they received as a tax refund, whether they're married and have children, and whether they ever clicked on a long list of tax forms that would reveal

more about their income and life events. The report also found that Tax Act had sent similar information to Google through its analytics tool, but that information did not include names. Oh, are they not merciful? Now, low income Americans are unsurprisingly, a especially vulnerable to having their information sold by these companies, especially because they're looking to take advantage of their free software services. The Congressional report found that some of the customers affected by the data sharing were using a free version of tax act that the company offers in conjunction with the IRS to help low income filers fill out their tax returns.

So apparently, while TurboTax shared its customers. users users names with user names with meta. The congressional report found that it did not provide any financial information. And if you think we're just talking about anonymous metadata here, you'd be making a huge mistake.

Much of the tax software data was transmitted in a way that was supposed to make the users anonymous. But the legislators contend that a technology expert could easily get around any attempt to make that data anonymous.

Meta also confirmed to these senators that the company uses the information from the tax software to target ads toward Facebook users, including ads for products, obviously other than tax prep services. In a letter to the IRS, Federal Trade Commission and Attorney General Merrick Garland, the Democratic senators behind the letter argued that the tax prep firms were shockingly careless, which with their treatment of taxpayer data. They indicated that they installed the META and Google tools on their websites without fully understanding the extent to which they would send taxpayer data to these tech firms,

without consulting with independent compliance or policy experts, and without full knowledge of meta's use of and disposition of the data. Now keep in mind, if a sole accountant, if one accountant decided to to share your taxpayer information, your personal information, they would very likely face criminal prosecution, a possible 1,000 fine, and even possibly a year in prison. Now Senator Warren and six other lawmakers are urging the Justice Department to act by criminally charging companies that violate laws preventing tax preparers from sharing their clients' personal information. They're also citing the latest congressional report revealing how the data sharing by

H&R Block, tax layer, and tax act is good reason for the IRS to build its own free tax preparation software rather than steering Americans toward private companies. So what do these tax preparation services have to say about themselves? Well, H&R Block swears it has changed its practices, providing a statement to the Washington Post, which reads, H&R blog takes protecting our client's privacy very seriously, and we have taken steps to prevent the sharing of information via pixels. Tax Act and Tax Slayer did not respond to inquiries from the Washington Post about the congressional report. As for Google, they claim to have very strict policies and technical features that prevent Google Analytics customers from collecting

data that could be used to identify specific people. Further, Google claims that, quote, site owners, not Google, are in control of what information they collect and must inform their users of how it will be used. Additionally, Google has strict policies against advertising to people based on sensitive information. Well, apparently not strict enough. And let's also keep in mind that Google was found to have taken the personal data collected by third parties, the tax prep services in this case, in order to target ads based on that data. So while Google claims one thing, it's important to understand that this congressional investigation discovered the opposite. And that makes sense considering we get to use Google

and most of the services that fall under its umbrella free of charge. But as we all know, nothing is truly free, folks. And Google is still a business. It's bread and butter, much like Facebook, is selling our data and selling companies the opportunity to tarsely. us with ads on their platforms. The real question is, outside of a congressional report and a strongly worded letter to federal regulators, will Democrats work alongside Republicans in Congress to protect our privacy and private data? And not just in this situation, in any situation involving websites, because they all do the same thing. Now the lawmakers who signed that letter included Democratic senators Elizabeth Warren, Ron Wyden, Richard Blumenthal,

Tammy Duckworth, Bernie Sanders, Sheldon White House, and there was one Congresswoman involved, Representative Katie Porter. I'm going to hold my breath on any genuine attempt to push for criminal prosecution of company executives who broke the law. Like, I'd love to see it, but the idea that corporations would be criminally punished for, you know, harming ordinary people through criminal prosecution is honestly laughable in America these days. Who knows, they might prove me wrong.

But their second solution is far more feasible and in fact is currently in the works. The Democratic lawmakers wrote that they welcome recent IRS announcements of a free direct file pilot next year, which will give taxpayers the option to file taxes without sharing their data with untrustworthy and incompetent tax preparation firms. I agree with them on that wholeheartedly. Now, tax preparation companies lobbied pretty hard to prevent the IRS from providing the service for free. For years, tax prep companies like Intuit and H&R Block spent millions of dollars lobbying the government to stop the IRS from providing an easy-to-use free file option. Republicans buddied up with them too, demanding that the agency stopped. competing with private companies.

Oh, brother is right. So these corporations brokered a deal, a deal that was really good for them and really crappy for everybody else. They promised to offer low-income Americans free tax prep software. And in exchange, the IRS wouldn't make a free-filing program

of its own that would be available for everyone. Well, since then, Since then, H&R Block and Intuit have undermined their own free-filing options, hiding them from search engine results and using slick design tricks so that customers end up paying more. Because let's be clear, these flimsy free options were never meant to be easy or useful. I mean, she's absolutely right about that. Now, currently, taxpayers who earn $73,000 or less can file their federal tax returns for free. About 70% of taxpayers fall in that category.

But that free filing service is not provided by the IRS. Instead, taxpayers must use a service from one of seven different private companies that make up an alliance known as the free file program. So in other words, the federal government had been funneling clients to private tax prep companies, some of whom were collecting and sharing personal financial information. Two largest private providers of tax preparation, H&R Block, and Intuit, together handled about 70% of returns filed through the free file program for the 2019 tax year. And that's according to the Congressional Research Service. Now, both of those companies have since withdrawn from that free file alliance, H&R Block left in 2020 and Intuit left in 2021.

And look, these public-private partnerships usually don't work out so well. Luckily, in May, the IRS announced a limited pilot of a government-run program that will be launched for the 2024 tax filing season. The pilot could translate to an official free IRS tax filing system, and that's what I personally think makes the most sense. And while I've been extremely critical, for good reason, of Biden's Inflation Reduction Act, the bill required that the IRS release a cost and feasibility study on developing a free electronic tax filing system. And their findings were telling. During this preliminary research phase, an internal prototype was created to help study how taxpayers would use the program, commonly known as direct file. And surveys found that 72% of taxpayers would be interested in using a free electronic tax

filing service offered by the IRS. Now, in a call with reporters, IRS Commissioner Danny Werfel said that the report shows that a majority of taxpayers are in fact interested in using an IRS provided tool to prepare and file their taxes. It also shows that the IRS is technically capable of delivering direct file, but that doing so requires additional resources and adds complexity to IRS operations, which makes the GOP-led effort to continue dismantling the IRS by defunding it, all the more worrisome, right? What that does is it provides less options for tax filers, and it leads to more tax filers leaning on these private companies, which are not only charging them, but also on top of

that, sharing their personal financial data to third parties, or with third parties. And look, it will be up to the Treasury Department to decide whether to move forward with a larger scale program after the pilot runs next year. And I really, really do hope that they go in the direction of making that pilot program an official free tax filing IRS program. We'll see what happens. But I think the real dream is what some other countries have been doing for a long time, which is not forcing their citizens to file taxes at all. They take out the appropriate amount of taxes from each paycheck, and then they're done with it. That would be really, really sweet.

But the tax system's way more complicated here in the United States. And in some respects, I think that that is not the bug, but the feature. Anyway, we'll update you all on that story as we learn more. But for now, I'm going to read a few comments because a lot of you are worked up about this, and I love that. We've got Doc Wagon Dragon in our Twitch subs saying that this is why I take the to do my taxes by hand. You and my dad, you guys are the same person.

This and I learned to do them by hand because there wasn't any other way when I first started and I don't mind reading and math. That's awesome. I love that. But there are a lot of people calling for criminal prosecution. So I do want to read a few more comments. We've got Athens on 61 who resubscribe for 18 months.

Love the show. You helped me be somewhat sane. Thank you so much. I am green ass or, oh, I'm sorry, imagine ass, writes in and says, seems like grounds for a class action lawsuit. I think that that might actually be a really interesting development should that happen. I do think that there should be more accountability because really right now, the only thing I see happening is a possible positive development with new IRS tools. But for the companies who clearly engaged in illegal behavior here, there should be some consequences for it. It might come in the form of a class action lawsuit, it might come in a different form, we'll see.

But it is important to know that any time you are inputting your personal information on a website or in software, it's very likely that they're collecting that data and they're sharing it with third parties as part of their business model. It happens with every website, except for our own. I don't think we do anything like that. But the point that I'm trying to make here is that this data collection and this lack of privacy that we're dealing with is very much real. And I don't think Congress has done enough to both hold companies accountable. But more importantly, pass legislation to protect us from this kind of creepy data

collection and these creepy privacy breaches. All right, with that said, we're going to take a brief break when we come We have more news, including some pretty shocking updates on what is happening with the drug policies in Portugal. Don't miss it. I'm your host Anna Kasparian. Let's get to our next story. This one really did shock me. When you look at a Portugal, you look at what some other form, would we tackle this better if we legalized it and regulated it? And I know that seems like a crazy notion. Of course. Look, but you look at some of the outcomes in Portugal and you think, well, maybe it's not so crazy. So I think Portugal is a very different country. And in fact, if you look at some of the strategies that have been tried in Portugal, some of them have been tried in certain municipalities in the United States.

States and what you end up seeing is drug overdose numbers go up, addiction numbers go up. So I think if the Portugal approach could work here, it would have frankly already worked. That was Republican Senator J.D. Vance from Ohio, making the case that while drug decriminalization worked in Portugal, similar models have not worked out so well in the United States. Now look, considering the pretty brutal spikes in overdoses and deaths in America each year, I was ready to at least hear him out. But he actually might be getting something wrong. In fact, we might all be getting something wrong. Okay, let's watch more and I'll explain what I mean. Look, some harm reduction absolutely matters, right? Suboxone to sort of medically assisted treatment

for people who are trying to break clean of this stuff. All that's part of the equation. But I think that if we believe we're going to solve the opioid problem by handing out needles, were going to make the problem worse. And in fact, we're already seeing evidence that we've done this. So, no, I don't think that's the solution. But I do think that we should follow the evidence wherever it ultimately leads here. Legalization is not going to help, but maybe doing medically assisted treatment more and making that more accessible, that's a good solution. Look at J.D. Vans mentioning Suboxone and medical treatments to help people who are suffering with addictions.

It's incredible. I mean, can we just address his tone and how much Vans? has moderated his messaging since running in the GOP primary for his Senate seat in Ohio. He even seems open to doing more than just, you know, locking people up for drug abuse. And he seems willing to admit that the model worked in Portugal. But as I was researching this story, I was actually shocked to find that tides are turning in Portugal. And their much lauded drug reforms are beginning to show cracks and weaknesses. Okay, so let's go back and refresh our memories of how Portugal reforms.

their drug laws. Back in 2001, Portugal ended punitive drug policies and instead decriminalized consumption of all drugs for personal use. Consumption remains technically against the law, but instead of jail, people who misuse drugs are registered by police and referred to dissuasion commissions. For the most troubled people, authorities can impose sanctions, including fines and recommend treatment. The decision to attend, though, is voluntary. So the so-called harm reduction model was born. That's what happened in Portugal.

And the initial results were absolutely promising. In fact, TYT covered Portugal's success story many, many times. Here's one example from 2012. And back in 2001, Portugal decriminalized all drugs. Now, we talked to you about the Portuguese experiment before, and that it seemed that it was going well with the numbers. Well, a new report is out, after 11 years of this experiment, how has it gone so far? Well, the numbers are in, and they are astounding.

The number of drug addicts being treated has dropped by half in Portugal. They cut the rate by 50%. What happened? I thought it was supposed to go up. No, there's far less drug addicts. And if you think that's an impressive number, drug-related diseases, including STDs and overdoses, have been reduced by an even greater number. Look, he wasn't lying. At that moment in time, August of 2012, data indicated that HIV transmission rates

through shared syringes had plummeted. And other metrics illustrated the success of the decriminalization policy as well. From 2000 to 2008, prison populations fell by 16.5%. Overdose rates dropped as public funds flowed from jails to rehabilitation. There was no evidence of a feared surge in drug use. The decriminalization policy in Portugal was so successful that in 2009, while writing for the Cato Institute, Glenn Greenwald reported that, quote, none of the parade of horrors that decriminalization opponents in Portugal predicted

and that decriminalization opponents around the world typically invoke has come to pass. And he was right about that. But things have unfortunately begun to shift in a scary direction. Officials in Portugal, including the very architect of decriminalization in the country, say they're noticing a steep spike in the number of people suffering from addiction. A newly released national survey suggests the percent of adults who have used illicit drugs increased to 12.8 percent in 2022. And that's up from 7.8% in 2001.

In other words, there are now more adults reporting illicit drug use today compared to the year the decriminalization policy was implemented with the very intention of lowering the prevalence of drug abuse. Portugal is still doing better than some European countries, and drug use there is still below European averages. So you've got to look at it all in context, okay? Analysis by the Washington Post found that Portugal's prevalence of high-risk opioid use is higher than Germany's, but lower than that of France and Italy. But what about overdoses? Unfortunately, that's where things start to look pretty bleak. Overdose rates have hit 12-year highs and almost doubled in Lisbon from 2019 to 2023.

Sewage samples in Lisbon show cocaine and ketamine detection is now among the highest in Europe with elevated weekend rates suggesting party heavy usage. Yeah, I think that suggestion is correct. Now in Porto, the collection of drug-related debris from city streets surged 24% between 2021 and 22, with this year on track to far outpace the last. Crime, including robbery in public spaces, spiked 14% from 2021 to 2022, arise police blame on increased drug use. And look, let's just pause for a second. That doesn't surprise me either. People who are addicted, especially if they're addicted to certain drugs like heroin, fentanyl,

if they don't get their next fix, they become dope sick. And they could even die in some cases. And so they'll do anything to get the resources in order to get their hands on their next fix. So that's why you'll notice, you know, instances of burglaries and stuff like that kind of spike in relation to or, yeah, simultaneously with a spike in, you know, drug overdoses and drug use. Anyway, not only does the Washington Post provide broad statistics on how the liberal drug policy has fared in recent years, They also detailed tragic stories of individuals struggling with addiction, leading any non-sociopathic person to feel quite a bit of despair. So take the story of one of the state-funded so-called squat houses on the south side of Porto as an example. The objective is to provide addicts a private place to use outside of public view.

But there are unintended consequences, as it enables some to hide their drug addiction from family members who might be able to stage an intervention. and help their loved ones get clean. Inside, a 47-year-old man struggled to mix ashy heroin with fragments of crystal crack, crushing both into a souped-up speedball. Observed by a nurse, he took the needle and jabbed it into a vein in his neck. The veins on his hands have dried up, the nurse said, matter-of-factly. I can't use at home, said another person at the center.

It causes too much trouble, so I make the drive an hour and a half here. And look, I also don't begrudge some who feel these policies do little to compel people who are addicted to drugs to get clean because fact of the matter is that's really not what these government funded organizations are interested in doing, and they're clear about that. In the tourist quarter, in the shadow of Porto's fortress-like cathedral, a social worker with a government-funded nonprofit handed out clean syringe packages to people who use heroin. When crack pipes are available, the social workers give them out. There's no judgment, few questions, and no pressure to embrace change.

Now, summing up that philosophy, a woman named Louisa Neves, who's the president of one of these nonprofits, said, quote, you have to respect the user. If they want to use, it is their right. Now, I think safe injection sites are important, incredibly important, in preventing the spread of deadly diseases. But how these sites are operated matters a lot. And we'll get to what I mean by that in just a moment. And while I want to reiterate that these policies were passed with the absolute best intentions. The unintended consequences are hard to ignore in recent years, but they can be fixed.

Now, over the last 18 months, a drug encampment in Porto sprung up below a school. More homes have been burgled. One neighbor said she found a person naked from the waist down, shooting up outside her house gate. Residents have launched U.S. style neighborhood watches and hired private security guards, something exceedingly rare in Europe. Police deployed in force. to the area three months ago to crack down on dealers who can be and are being arrested. Patrol cars are now stationed in the neighborhood 24 hours a day, scattering people using drugs. And the mayor of Porto recounts a contradiction spurred by the policy that sounds honestly all too familiar to those living in coastal cities in western United States.

These days in Portugal, it is forbidden to smoke tobacco outside of school or a hospital. It is forbidden to advertise ice cream and sugar candies, and yet it is allowed for people to be there injecting drugs. We've normalized it. By the way, the mayor of Porto does not want to reverse the decriminalization law in Portugal, but he is calling for some tweaks, and we'll get to that in just a moment. Now, even the head of Portugal's National Institute on Drug Use and the very architect of the decriminalization policy in the country, admitted to local press in December

that, quote, what we have today no longer serves as an example to anyone, his words, not mine. But he's not ready to fully reverse the policy, and I'd agree with him. Instead, he wants to make improvements, and there are two things that stand out to me while looking at this story closely. For one, the program started with the government carrying out services following decriminalization, but later outsource the work to nonprofits. So Portugal decentralized its drug oversight operation in 2012. A funding drop from 82.7 million to 17.4 million forced Portugal's main institution to outsource work previously done by the state to non-profit groups, including the street teams that engage with people who use drugs.

The cut in funding quite clearly had a terrible impact and weakened Portugal's successful program. Also speaking from personal experience here in Los Angeles, leaning on publicly funded non-profits to carry out the job is a terrible idea. For one, there tends to be a lot of waste. Just look at the insane six-figure salaries of the executives for these nonprofits and how much money they take home every year, paid for by the taxpayer, of course. Also these non-profits would no longer serve a purpose and would no longer receive government

grants if drug abuse issues were solved. We certainly wouldn't need as many of them if these issues were mitigated through other means. There's an inevitable conflict of interest, and I'd rather have a centralized government program. Luckily, Portugal is headed in the right direction and is now moving to create a new institute aimed at reinvigorating its drug prevention programs. As with many liberal US cities, Portugal's lack of emphasis on rehabilitation while pursuing harm reduction strategies is also proving to be a problem. The number of users being funneled into drug treatment in Portugal has sharply fallen,

going from a peak of 1,150 in 2015 to 352 in 2021, the most recent year available. And what about so called dissuasion commissions, the commissions I mentioned earlier that are supposed to, you know, talk to people and try to encourage them to get clean? Well, of two dozen street people who, by the way, that's the Washington Post wording, not mine, but of the two dozen people who used drugs and were asked by the post, not one said they'd ever appeared before one of Portugal's dissuasion commissions envisioned as conduits to, funnel people with addiction into rehab. Now look, identifying the flaws, the current flaws in Portugal's decriminalization model is critical if we want to avoid circling back to destructive war on drug policies. Some of the earliest adopters of liberal drug policies, unfortunately have now begun reversing course. Consider lawmakers in Amsterdam and how they decided to institute a ban on smoking pot in public places.

I mean, honestly, that reversal seems a bit overboard. But it's also worth noting Norway's decision to implement a Portugal-like plan to decriminalize drugs. Well, that fell apart in 2021. And cities across the U.S. have implemented, in their minds, Portugal's model because of how successful it was in the beginning. And to be fair, I'd be shocked if municipal lawmakers were aware of the latest day of, and how it demonstrates otherwise.

In fact, numbers coming out of states like Oregon make it pretty clear that they are unaware of some of these issues and flaws. In Oregon, where the policy took effect in early 2021, openly citing Portugal as a model, attempts to funnel people with addiction from jail to rehabilitation have had a rough start. Police have shown little interest in handing out toothless citations for drug use. Grants for treatment have lagged, I would really emphasize that part. And extremely few people are seeking voluntary rehabilitation. Meanwhile, overdoses this year in Portland, the state's largest city, have surged 46%.

And if you zoom out and look at the United States overall, the numbers are stunning and incredibly tragic. So in the United States alone, overdose deaths fueled by opioids and deadly synthetic fentanyl topped 100,000 people in both 2021 and 2022. And that's double what it was in 2015. Look, people are dying and we need to find a way to reverse this trend. We desperately need to find a way to save lives without going back to overly punitive policies. Let's just pause for a second. I want to reiterate that. I do not want to go back to war on drugs, war on drugs, like overly punitive policies.

they did not work. They were not good. I do think that we can save this model, but we need to make some tweaks. The problem is people are unwilling to ever admit that something isn't really going as well as we thought it was going, or that there might be some flaws that we might want to work on. Because if we don't learn from Portugal's mistakes or our own, we definitely will go to war on drug policies and mass incarceration. That, again, does nothing to actually. actually deal with why these individuals have drug addiction issues in the first place, right? It's not going to do anything to actually help them get rehabilitated. Now Portugal also commits far more of its resources to social spending programs.

So for anyone who might think that, well, you know, maybe the problem in Portugal is the same problem we have here in the United States. Root causes, root causes, it's because of poverty. Not quite. The OECD defines this as expenditures targeted at low income. households, the elderly, disabled, sick, unemployed, or young persons. Now, Portugal not only dedicates a higher percentage of its GDP to social welfare spending compared to the United States, and that's again, according to OECD data, it also has a

much better health care system. While it definitely isn't perfect, all residents in Portugal have access to health care, so they have universal health care provided by the National Health Service, which is funded mainly through taxes. They still have co-payments and health care delivery is based on both public and private providers. So while it's not a single payer model, they do have universal health care in Portugal, yet they're still having the same problems we're experiencing with drug addiction here in the United States. So sometimes the issues that we're seeing need more than more social programs. I think Portugal's model is promising, it shows that it worked.

They made some changes beginning in 2012 and those changes were not positive ones. They did not have a positive impact. But that's okay. Clearly they're reversing course and I'm excited to see how the numbers change now that they're going back to a centralized government model that takes care of the services associated with their drug policies instead of kind of outsourcing them to these, nonprofits. But the point that I'm trying to make here is sometimes you have to adapt to the situation changing. And clearly the situation changed in Portugal. And if we're going to point to

Portugal as a success story, if we're going to implement Portugal's policies in US cities and use Portugal as an inspiration, we just got to make sure that we implement it correctly. Because my fear is if we don't, if the policies fail, the pendulum will swing in the opposite direction And we need to prevent that from happening. All right, we got to take a break when we come back. More news for you, including what private equity firms are doing to our already broken health care system. Welcome back to the show, everyone, Anna Casparian with you. Got to listen closely to this next story.

Because if you think that our health care system was already broken, don't worry. There are very fine gentlemen in the country that are working to break it even more. So let's talk about private equity firms and what they've been up to, what they've been buying up, and how they're harming us in what they're doing with health care in America. It's a growing complaint across the country. nurses concerned profits are put ahead of patients as more private equity firms take over health care groups. We've been covering how private equity firms have been snatching up health care services and groups across the country, leading to rising health care costs and, if you can

believe it, an even more broken system than what we already had. The latest development in this ongoing trend is that private equity firms are now buying up anesthesia practices and sharply raising prices to turn a profit. In one jarring example, in less than a year, the multi-billion dollar private equity firm known as Welsh, Carl Carson, Anderson, and Stowe created Colorado's biggest anesthesiology practice. I'll have more on that in a moment, but first, here's a reminder of how private investments in health care have impacted patients in need of care. Today, it's estimated over 40% of the nation's emergency departments are overseen by for-profit staffing companies, all of them owned by private equity. These Wall Street firms look for a return

on their investments on a shorter timeline. And academic researchers tell us the largest profits are often in the ER. How does that affect patient safety? What I was concerned with is having an adequate time to do the job properly. As our volumes grew and the popularity of our ER grew and our responsibility grew, it became clear to us that my physicians were being asked to be in three places at once. Brevant says that wasn't the only problem. He says doctors and nurses were expected to improve metrics by admitting more patients without adequate exam time or bed space. Wow, isn't it just wonderful that our government is turning a blind eye to profit-driven speculators who treat patients experiencing medical emergencies like garbage? These patients

represent dollar signs. The more the better. Get them in, push them out. Who cares about the quality of care? Look, now back to the private equity firm, Welsh, Carson, Anderson, and Stowe, and the impact they've had on anesthesia practices. The firm is quickly monopolizing the market in Colorado specifically through a company the financiers created called U.S. anesthesia partners. In 2015, the company bought the largest anesthesiology group in the Denver region, but they weren't finished. Then they bought the next largest. Then it bought a few more. The company employed 330 anesthesiologists in Colorado at one point, according to its website, making it the state's largest practice by far. It obtained contracts at 10 of the region's 15

largest hospitals, and that's according to the hospitals. In fact, since its founding back in 2012, USAP has built a staff of more than 4,500 clinicians across nine states. Antitrust laws would have one believe that federal regulators should, you know, maybe do something about this. And to be fair, the Federal Trade Commission did inquire about the acquisitions, but that's about it. The FTC ultimately decided to do nothing. And this has been the rule, not the exception. Dr. Robert McNamara is the chair of emergency medicine at Temple University. He's also the chief medical officer of a group representing about 8,000 emergency doctors nationwide.

Do you think private equity firms should be in the business of medicine? Certainly not in emergency medicine. You're having people that are seeking to make us significant profit off of health care. There are laws on the books to prevent the corporate practice of medicine. Are they not being enforced? No, they're not being enforced. McNamara says state attorneys general rarely prosecute these types of cases, and doctors often don't speak up for fear of losing their jobs.

And these are a billion-dollar companies that you're fighting. You're fighting Wall Street. And I mean, Wall Street reigns supreme in the U.S. doesn't it? Now, after Welsh, Carson, Anderson, and Stowe, the bulk of anesthesiology practices in Colorado and managed to dominate that market, the firm proceeded to do what it intended to do all along, raise prices. The company raised prices for its services, won by nearly 30% 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 one in three leaving the company over a three-year period. This is it. This is what they do. Private equity firms, like Welsh Carson, have become critical players in health care economics, with private equity funds acquiring hundreds of physician practices across America, and according to multiple academic studies, raising prices while returning billions of dollars to their investors. A 2020 study published in JAMA, internal medicine, based on six years of data, found that when anesthesia companies backed by

private equity investors took over at a hospital outpatient or surgery center, They raised prices by an average of 26% more than facilities served by independent anesthesia practices. Since its founding in 2012, it has issued more than $1.3 billion in dividends to its shareholders. I just want to pause for a second and address the impact this has on insurance premiums. Now, there is a lot of bad behavior going on when it comes to you know, various hospitals, various doctors, in this case, companies backed by private equity firms, overcharging private insurers for various services. Do you think the private insurance companies just eat it?

Or do you think that they, you know, pass those costs on to the people who buy insurance and need insurance? So we all pay more for insurance due to the greed of these private equity firms. And that's on top of patients, specific patients having to pay more for services because these private equity firms are looking to increase their profits. I mean, how else are they going to provide those sweet, sweet dividends to their investors? Now, the company claims that they have significant competition and that negative information reporters are getting from people are actually just disgruntled former physicians. Right. Now let's look at the facts, okay? So company officials did not share annual price increases on contracts, but said the companies, but they did say that the company's negotiated rates with insurers in Colorado rose at a rate of 3.7% annually from 2014 to 2019. That's a total increase of 20% over the five-year period, meaning USAPs prices rose.

twice as fast as median prices measured by a national survey by the American society of anesthesiologists. In fact, the company raised prices so much that the insurer United Health dropped them. In fact, the insurer said it had singled out the USAP contract for termination because the company wanted to charge 70% more than competitors in Colorado and twice as much as competitors in Texas. And when the FTC raised concerns about their business practices, they sent anesthesiologist Peter Harkness, who was the chairman of the Clinical Governance Board of USAP's Colorado branch at the time, to Washington, D.C., to lobby. But there's a twist. He's now suing the company.

Harkness told the Washington Post, quote, I was given talking points for the FTC meeting, but I'm a doctor, not a businessman. The USAP led us to believe what would happen is that we were going to be the premier practice in Denver. Patients and quality would be the first priority. And look, it didn't turn out that way. Harkness and other USAP physicians basically said that they couldn't provide quality care. And what the practices ended up doing is monopolizing markets and then using their large company leverage to negotiate higher payout. from private insurers, thus jacking up health care prices for all of us.

Though their prices have risen, the company said hospitals and patients have saved money because USAP's patients spent fewer days in the hospital. But come on, let's keep it real. They spend a shorter amount of time getting the care they very likely need because these firms seek to increase patient turnover to increase profits. It's baked into their business model. So why are we allowing this kind of speculative behavior to be tied to our health care industry? And once you understand all the different players who are involved, all the different entities and corporations that make a ton of money, a killing off of this broken health care model, you get a better understanding as to why it's so difficult to even get something like a public option.

You have to understand the system, the players who benefit from it, and come up with an actual strategy to get us to where we need to be for a better health care system. In the meantime, if these private equity firms continue to have these cozy relationships with our elected lawmakers, I mean, Biden is very friendly with the head of Black Rock, for instance. I mean, all of these issues end up leading to deregulation or less government oversight. I don't know why the FTC decided to allow these acquisitions to take place, especially since Lena Kahn has been far more effective and aggressive in pursuing antitrust cases. But we do see what the impact is, and people are not going to be able to get the care they need,

and they're going to pay a lot more for that crappy care as long as we allow speculators to have this kind of control and impact on our health care system. We've got to take a break. When we come back, John Ida Rola will join me for the second hour. Don't miss it.

Thanks for listening to the full episode of the Young Turks. Support our work, listen ad-free, access members only bonus content, and more by subscribing to Apple Podcasts at apple.com slash t-y-t. I'm your host, Shank Huger, and I'll see you soon.