The Worst Kind of Corporate Greed
A group of bioarcheologists studying a fossilized bone dug up in Spain concluded that, about 146,000 years ago, Neanderthals cared for a child with Down syndrome. The discovery, published recently in the journal Science Advances, said the child lived to the age of six, which was a long time for a disabled child in those days.
They also noted that the child needed more help than its mother could provide, which probably meant that other community members helped out. That’s more than I can say about how the Neanderthals of today treat disabled people.
Much has changed in 146,000 years. Today’s Neanderthals have figured out how to efficiently wring maximum profits out of people with disabilities. I feel the sting of it in my everyday life. During those dreadful times when my motorized wheelchair breaks, I contact the company that sold it to me, Numotion, which also repairs it. My friend Sarah, who lives in Austin, Texas, and also uses a power wheelchair, calls the company “Nomotion.” In both of our experiences dealing with it, several weeks usually pass between the day we contact the company and when our wheelchairs are working again.
This makes the painful experience of having a broken wheelchair even worse than it is normally. But few alternatives exist to calling Numotion for wheelchair repair because of the influence of raw capitalism on the wheelchair sales and repair market.
A report titled “Private Equity in Durable Medical Equipment,” put out a year ago by the Private Equity Stakeholder Project (PESP) and the National Disability Rights Network, illustrates how “private equity profits off of disabled and chronically ill Americans.” The report says that two of the leading wheelchair suppliers are Numotion and National Seating & Mobility (NSM)—both owned by private equity firms.
Let me pause here to make sure everyone understands the obvious: The only reason private equity firms invest in anything is because they see it as a means of making a lot of money fast. That’s why these firms exist in the first place. If people get hurt in the process (such as employees losing their jobs or customers receiving increasingly lousy service), too bad; that’s just the way the capitalist cookie crumbles.
So it makes sense that dealing with Numotion is a stressful experience that has gone from bad to worse over the years. And it appears that Sarah and I aren’t the only ones having these troubles: The report shares horror stories from other Numotion customers, too. There’s Ian Watlington, from Washington, D.C., who waited six months for Numotion to repair his broken wheelchair. Maureen Amirault, from Connecticut, shared how her chair broke down four times in less than two years; each time, it took Numotion six to eight weeks to fix it.
Carol Berger, also from Connecticut, said NSM didn’t fix her custom wheelchair for more than three months, and they didn’t have any loaner chairs to offer her in the meantime. Instead, she had to use a manual chair, which left her in “excruciating pain” every day.
I reached out to Numotion for comment but did not receive a response by press time.
“Due to the private equity industry’s extreme focus on profit, patients are forced to endure potentially life-threatening delays, costs, and legal hurdles to access the equipment needed to manage their health,” PESP said in a statement.
The report urges states to support timely repair legislation, as many people are subject to “extraordinary wait times for replacement parts and service of their wheelchair.” Even the companies themselves say that customers should be prepared to wait months for replacement parts. Yet these private equity firms openly lobby against the passage of such legislation.
On one occasion when I needed my wheelchair repaired, I became so frustrated while dealing with Numotion’s insensitive bureaucracy that I solemnly swore that I’d never call the company again. The people I talked to seemed to have no sense of urgency when it came to fixing broken wheelchairs.
I told my wife, who also uses a wheelchair, that I wanted to drop Numotion and take my business to the company from which she bought hers. Unfortunately, that company is National Seating & Mobility (NSM). Her experience in dealing with NSM has often been equally frustrating. So I went back to Numotion. No, I’m not a glutton for punishment; I just feel like I’m stuck with the company.
The report says that both companies, created through a series of acquisitions and mergers, have “gobbled up competitors and achieved dominant positions in the market.” Numotion was created by a merger of two smaller companies in 2013, and since then, it has acquired at least twenty-five of its competitors. Since a private equity firm bought NSM in 2013 (it’s owned by a different one now), it has acquired at least forty-two other companies, the report says.
With its “laser focus on boosting profits at all costs,” private equity “creates many of the problems for consumers through its own cost-cutting policies. People who rely on DME [durable medical equipment] should not pay the price for private equity’s gamble,” the report adds.
DME includes far more than just wheelchairs. Other essential tools that people with disabilities and chronic health conditions rely upon include walkers, infusion pumps, oxygen equipment, hospital beds, and sleep apnea equipment. At least fifty DME companies are owned by private equity firms, according to the report.
Private equity firms aren’t just sticking their noses into the DME market, either. PESP, a nonprofit whose mission is to “identify, engage, and connect stakeholders affected by private equity,” also released a report in 2022 titled “The Kids Are Not Alright: How Private Equity Profits Off of Behavioral Health Services for Vulnerable and At-Risk Youth.” The report notes that, since 2017, “a flurry of private equity acquisitions” of autism service providers has occurred.
“For example, in 2018, the Blackstone Group acquired the Center for Autism and Related Disorders, with close to 2,000 employees, for a reported $700 million.” In 2021, “Cerberus Capital Management acquired Lighthouse Autism Center from Abry Partners for over $400 million.”
According to “Private Equity in Durable Medical Equipment,” from 2008 to 2021, Blackstone Group owned Apria, one of the leading providers of in-home respiratory support equipment. During that period, the report says Blackstone “reaped hundreds of millions of dollars in dividends and fees from Apria, even while the company was under investigation for fraud.”
The federal government seems to have recently grown concerned about the presence of private equity firms in industries that serve people with disabilities. In March, the U.S. Department of Justice’s Antitrust Division, along with the Federal Trade Commission (FTC) and the U.S. Department of Health and Human Services, issued a joint request for information about the impact of health care mergers, acquisitions, and other transactions by private equity funds and other business entities.
“Given recent trends, we are concerned that some transactions may generate profits for those firms at the expense of patients’ health, workers’ safety, quality of care, and affordable health care for patients and taxpayers,” the joint request by the agencies states.
The information will help the agencies determine “enforcement priorities and future action, including new regulations, aimed at promoting and protecting competition in health care markets and ensuring appropriate access to quality [and] affordable health care items and services.”
Among other things, the PESP report on the DME industry urges the FTC to “examine anticompetitive practices within DME markets,” including transactions involving private equity firms that “do not meet the typical threshold to trigger FTC review.”
A ninety-day public comment period on the request for information generated more than 6,000 responses. But even if significant federal or state intervention happens, it remains to be seen whether it will result in our broken wheelchairs getting up and rolling again in a reasonable amount of time. That’s the bottom line for a lot of us.