If you are not a golfer or fan of golf or perhaps live in a cave you have no idea the upheaval that has been heaped upon the big world of the little white ball. More importantly it has shown just how vapid the titans of industry are when it comes to principle and loyalty. 

In short, the PGA and the LIV golf tour decided to put down the switchblades and see if they could make nice. LIV has been throwing around a lot of money on a few stars and a lot of has beens. They have been getting nowhere in attracting a following and more importantly media and corporate backers. 

On the other hand the PGA was looking forward to endless lawsuits from a bottomless money pit called the PIF or the Saudi Sovereign Fund. Who do you think will outlast the other? Between Greg Norman and the country of Saudi Arabia you have enough villains to really piss off a lot of people. Jay Monaghan of the PGA appealed to the loyalty of the players and the hearts and minds of the 9/11 victim’s families. He is now running for Slug of the Western World. Should be a shoo in. 

If you don’t give a crap about any of this please, bear with me. The long shot of it is that money can buy everything from jewels, to mansions to people’s souls. We have monetized everything in the wonderful world of sport. Trademark bearing uniforms in every sport and perhaps even down to jock straps. You can bet on every aspect of the game from whether the next pitch is a ball or a strike or how long it takes to sing the Star Spangled Banner. All good clean fun. Ha!

And now the beauty of streaming. Whether it is the Yankees or the Boise Bears you can watch your favorite team on a myriad of channels. All the years it has been for free and the honeypot got shared by big TV and owners of the teams. We pause this interlude to let you know that you will eventually pay for each specific game. ESPN, CBS et al are only going to give you access through streaming for a monthly fee of $60-90. What a deal ! In short those gazillion dollar salaries are going to be paid for good old Joe Six Pack or your local gin mill. 

Let’s get off sports for the moment. Prior to the golf menagerie, I have been deep diving into none other than hospice. I came across an article a few months back on the role of private equity in our industry.

 Now private equity is basically a large fund that buys up a bunch of businesses in a field and streamlines them. They cut staff and expenses and up revenue. They do all this by taking out huge loans to both buy and modernize. When things really get cooking a few years later they sell the businesses at a pretty healthy profit. The American way. Always saying they made the industry better and more profitable. Not exactly. 

Enter hospice. Prior to funding from Medicare, hospices were charitable organizations funded by donations. Several were religious or part of non profit hospitals.

They were small and struggling and they had this stupid notion of being a service to the community. Medicare was a welcome respite from sparse funding. As time went on, a few people caught on the notion this could be a gravy train and more and more started to get into the business.  

Whether inept or illegal, the industry does not have a lot of safeguards unless you are big and then they pay attention. Stay under the radar and you can do just fine. Yet watching all these people make money caught the eye of private equity and they started buying. 

Using their SOP they jumped in and decreased staff and increased claims to Medicare. Aggressive marketing put quotas on finding people who were dying and signing them up. They roamed the halls of hospitals and nursing homes. They went out in the backwoods of rural America. They get a per person fee everyday whether the patient is seen or not. They use a lot of inexpensive staff.  It was and is a license to steal.

Now some may say this is just capitalism at its best. Some say they are making the system better. I say BS. Our hospice is  a non profit. Our margins are small and we rely a lot on private donations. We take indigents and tough cases that require a lot of time effort and yes love. I say this not to brag about us but to say this is the way it should be done. I find it beyond distasteful that investors in private equity are making money off people dying. Maybe that is just me. Private equity is the largest owner of hospices nationwide and are scooping up more and more everyday. 

I say all this because big money is into everything from rehab clinics, to treatment centers to pharmaceutical distribution. Just like golf and every other sport. We have created the mega wealthy set. All the players reap absurd salaries and fringe benefits. Now that is fine if you start a business with your own money and nurture it. But at medicine and hospice I draw the line. People, we are the ones paying for all this through Medicare and Medicaid. It is our largess that is so often doled out without oversight. 

I was talking with an old friend who is by no means poor. We wondered who are all the people buying mega mansions, yachts, and works of art? It came down to a discussion about wealth and obscene wealth. We really have lost our way when it comes to ostentatious behavior. I am not at all jealous but saddened. If we can make megabucks from people dying or healing the sick then I think we really have lost our moral compass. Again, maybe that is just me. What do you think?

As always,

Ted The Great 

Factoids:

A major owner of for profit hospices was recently fined $200 million for lack of documentation and questionable claims. Paid as a cost of doing business. There are over 5,000 hospices in the United States. 66% are for profit. It is a $45 billion industry. 

The CEOs of approximately 300 health care companies collectively took home more than $4.5 billion in 2021, according to a STAT analysis of hundreds of financial filings. Regeneron Pharmaceuticals CEO Leonard Schleifer represented 10% of that total on his own, pulling in an astounding $453 million.

Lionel Messi, soccer star is being paid over $400 million a year to play for Miami. Tiger Woods was offered $800 million to play on the LIV golf tour and turned it down. And all they do is play a game.

We purchased almost $100 billion of lottery tickets in 2022. Interestingly almost two thirds of that was spent on instant scratch off games. In 2021, the market size of the casino and online gambling industry worldwide reached a total of $231 billion U.S. dollars.