And here’s a ChatGPT summary of it for the TLDR crowd:

Private equity ownership of hospitals and medical practices is linked to worse patient outcomes, higher prices, and weakened physician autonomy. The paper argues that PE’s standard playbook — heavy debt loading, cost-cutting, consolidation, and short-term profit extraction — is fundamentally misaligned with long-term medical care. Case studies like Hahnemann University Hospital show how sale-leasebacks and aggressive financial engineering can push essential hospitals into collapse. Consolidation of physician groups reduces competition and raises prices for patients and employers, while staff cuts and reduced investment correlate with lower care quality. The author calls for stronger antitrust scrutiny, transparency of ownership, and limits on practices such as asset-stripping to prevent further harm in the healthcare system.

>The long and short: In 2010, private equity firm Cerberus Capital Management purchased Caritas Christi Health Care, a struggling eastern Massachusetts hospital system, from the Archdiocese of Boston, converting it from non-profit to for-profit and rebranding it as Steward Health Care. In 2016, after years of continued financial instability, Steward signed a sale-leaseback agreement with Medical Properties Trust (MPT), selling the land and buildings occupied by its hospitals to the real estate investment trust then leasing them back. Steward made $1.25 billion from the agreement—enough to steady its financial footing, pay off Cerberus, and fund a growth spree. The next year, the company purchased 26 more hospitals across the country. But with the agreement came what many viewed as inflated rents.

Then read below "Consequences of cost-cutting".

"'This is starting to show up to be the problem that I've been referencing… that private credit and private equity, frankly, is being borrowed from private equity. It's sold on a volatility argument, primarily," Gundlach added. "Maybe there's some excess return for your illiquidity that you can get, but it's largely a volatility argument.'

Illiquidity could turn paper losses into real ones, Gundlach cautioned, pointing to the kind of liquidity squeeze that worsened the 2008 financial crisis, when investors were unable to meet capital calls."

https://www.foxbusiness.com/markets/jeffrey-gundlach-says-cr...