None of this is to say that PE firms squeezing vital hospitals aren't morally culpable. Just that there's a meaningful distinction between immoral decisionmaking and violence.
None of this is to say that PE firms squeezing vital hospitals aren't morally culpable. Just that there's a meaningful distinction between immoral decisionmaking and violence.
Life is considered valuable in integer quantities but fractional life is considered value-less.
People are free to do, endorse, concoct and peddle all sorts of things that waste people's time (life) or waste people's money on the basis that it "saves lives" because it prevents lives from being lost in whole numbers but the sum total of the little fractions ad up to more.
Thus, I have no trouble asserting that PE firms commit intentional violence against patients.
Indirection allows you diffuse the responsibility into the anodyne 'immoral decisionmaking' while social murder remains as it ever was.
It isn't 'all the drivers' fractionally at fault (others can quibble about that), it's the people who create the moral hazard. The car industry and politicians that decided that the ungoverned car, the road, and the parking lot will be the only way to traverse Dallas or LA lo those many years ago, the ones that affirm that system with 'one more road' using tax dollars year after year, knowing that more people will die as a result. https://en.wikipedia.org/wiki/Motor_vehicle_fatality_rate_in... <- the line goes up.
They have a duty of care as representatives that they are failing to meet. Compare that to cities in Europe or the North East. When you make policies that serve the few and sacrifice the bodies of the many, that act is violence.
Likewise, with PE. When they intentionally understaff a hospital, no single doctor is responsible for killing the patient that died bleeding in the waiting room. It is the choice that we allowed that PE firm to make. Are you comfortable with a fresh MBA using excel to ensure that your local hospital should have four less doctors than strictly necessary to treat you in a timely manner? Society doesn't need to be organized this way, we can and should demand better.
Imagine the reverse, a municipality decides to privatize their water and sewage treatment, but puts no restrictions on the results as long at those wealthy enough are not inconvenienced. This is precisely how you get Flint. Or redlined cities that put the 'undesirables' in industrial waste parks. These acts are violence.
I'm sure the concept has a lot of utility philosophically, but when you try to distill it down to "PE firm owners are murderers" you wind up in pretty crazy places unless you supply a lot of motivated reasoning and special pleading.
Everything is not everything else. Scale not only matters, it's almost the only thing that matters.
I mean, is Hitler a murderer? Is your run of the mill burglary gone wrong worse than the Holocaust? Obviously not. So there has to be some kind of understanding of organized death.
The concept being - organized or institutional crimes are real, and can be much, much, MUCH more severe than murder.
Consider that when speeding, you might cause an accident. Such an accident would most likely impact a small number of people other than yourself.
When a PE firm engages in extractive hospital management, it provably increases mortality rate, and it does so at scale.
The first choice carries possible risks of lower magnitude, the second choice carries guaranteed risk of higher magnitude.
“Risky behavior” vs “ruthless greed”, the latter feels much closer to violence.