Maybe these private equity firms are trying to create incubators out of these autism centers for new startup ideas..

Americans are deeply divided on the big bad guvmit

I know of a childcare center that was acquired recently. Not sure if by PE or just another business, but the employees are less than thrilled with the changes.

A rule of thumb is that benefits cost an employer 25-30% of salary. So you're already pushing to 50% of revenue going to direct salary costs. Then there are employees in non-revenue roles (HR, legal, accounting, IT, etc...) and employees doing non-revenue work.

Finally, you have rent, licensing, insurance, and all the other fixed costs.

They are much more likely to continue shoveling cash into private businesses through subsidies then to want to setup and/or run the same business for a fraction of the cost.

In many countries, essential services like hospitals, drinking water supply, airport security, schools, even prisons are now partially or fully privatized. It seems insane when you think about it, but that’s what your grandparents voted for.

We don’t want to pay for them. When private equity is forced to sell, someone has to buy or the providers get shuttered.

On the other hand, we’re clearly willing to blow the money and deficit on stupid stuff. But only if it goes boom, apparently.

When you review the findings on the standard behavioral intervention, autism, on average requires 2.5 years of 40hr/week.

Thats basically one persons job.

It's hard to argue against those who say private equity ruins everything. It's astonishing. And massively depressing.

You can download for free when you search the 'net for Founderstowne.

Moderate and below that I think you can live a pretty free life. Its not like down-syndrome. Autism is surprisingly normalized.

And usually it's not a problem, of "Throwing more money at it", but lack of regulations and enforcing them.

That said, Physician Owned Clinics have better outcomes, there is no reason why that shouldn't be the standard model of operating them. Usually they have more moral scruples about worsening care for profit.

Also there is naturally more competition, if there are multiple small operators instead of only Fresenius Nephrocare or DaVita

https://www.cbsnews.com/texas/news/death-rates-at-u-s-dialys...

The NDIS is our disability welfare scheme, and it's costs have exploded as oversight has failed to keep pace with exploitative actors. Few questions asked welfare for our vulnerable would be nice, but sadly it doesn't look sustainable in most places.

Social programs have been funded, show poor results, then seem like dead ends because of fraud.

Stealing money put aside to help the less fortunate is far more heinous imo.

A few months ago i got an email saying that PE had acquired it.

I was paying between ~$25/month before. Today i got the first bill from new management for $89.

Same volume/usage, nothing significantly different.

Sigh.

Where is this 'join' translated from ?

Individuals or family holdings are more likely to have concern for their reputations in addition to finances, public companies are more likely to scrutinized offsetting what would be their much lower reputational concerns. But PE is diffuse and often distant enough to eliminate human reputational concerns while being held to far lower stadards than public companies.

A family introduces some perverse financial incentives but you also get long term (ie multi generation) planning and reputation concerns.

A group of practicing professionals who own the operation will hopefully exhibit some shared pride and professionalism.

A co-op or similar arrangement ties the interests directly to the local community.

The larger the public company the less overlap there will be with the customer's interests. At least they might worry about reputation and stock price though.

Pretty much the only concern PE has is avoiding litigation. Their primary motivation is maximizing value extraction over the short or medium term.

1. PE aren't investors like you and me. We can go to our brokerage and buy shares of a public company, hold those shares, vote on directors and proposals, etc... Or we can buy and sell ETF/mutual fund shares that own companies. Then, we (or fund managers) can sell those shares after any period of time we want. Could be years, decades, or minutes. Whatever meets our investing goals. The same is actually true for hedge funds. We buy a a piece of a company, hold it as long as we want, then sell to take profit/loss. When PE buys a company though, they buy the whole company AND they have a specific timeline in mind. This is because PE firms are actually temporary private "investment funds": partners put in money and expect a certain return on investment after a certain period of time. At the end, that's when the fund needs to wind down and return capital + returns. So, there's already a ticking clock on anything a PE firm buys, and pressure to generate return before time runs out. They typically do this by taking a company public on the stock market (maybe again) or selling it to someone else. (This doesn't always succeed, but there are other options then, like continuation funds.)

2. PE funds also take on a lot of debt. They can't afford to buy whole companies or roll up entire industries just with their investors' funds, so they borrow a lot. Now, the companies they buy for their portfolios not only need to generate returns for their investors, they also need to do that AFTER making payments on that debt. It multiplies the pressure.

There are a lot of cases where PE bought struggling companies, and with discipline and incentives turned things around on a timeline. But there are also a lot of cases where PE bought stable but boring companies, used debt and pressure to force them to raise prices, cut services, lay off workers, and lower quality in order to generate returns at the pace required.

(Most of this I learned from reading Matt Levine columns, I'm not an expert and don't work in this industry at all, so I may have some details wrong.)