Who owns the hospitals, nursing homes, and schools we rely on?

The private-equity playbook is the same across industries: acquire a business with borrowed money, cut costs and consolidate, then sell at a profit within about five years. Applied to a software company, that's ordinary finance. Applied to a hospital chain, a nursing home, or a school network, it collides with something that isn't supposed to run on an exit clock — continuity of care, and continuity of education.

These sectors are attractive to consolidators precisely because we can't easily walk away from them: demand is steady and recession-resistant, ownership is fragmented and ripe for roll-ups, and the people paying rarely have the time, information, or leverage to shop around mid-crisis. When the debt and the cost-cutting land on a hospital, the consequences are measured in staffing, prices, and sometimes closures — not quarterly earnings.