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29 J. Health Care L. & Pol'y 1 (2026)

handle is hein.journals/hclwpo29 and id is 1 raw text is: HEALTH CARE FINANCIALIZATION ERIN C. FUSE BROWN HAYDEN ROOKE-LEY ** Abstract*** When a private equity-backed hospital cannot afford basic medical supplies, and patients die as a result, the problem is not merely mismanagement but health care financialization a shift from caring for patients and communities to extracting wealth for investors and executives. Arising in both for-profit and nonprofit institutions, financialization manifests in three ways: governance moves from clinicians and community stakeholders to financial actors; profits derive from financial engineering and labor suppression rather than value creation; and accountability is obscured through consolidation, delocalization, and intricate corporate structures. These dynamics are evident in private equity's leveraged buyouts and asset-stripping of providers, and in Medicare Advantage insurers' vertically integrated delivery systems. In both, financialization drives higher spending, degraded care, and clinician demoralization particularly troubling in a system funded largely by taxpayers. Recognizing that health care still relies on private capital, the Article outlines a policy framework to foster productive investment while constraining extraction, and calls for governance that centers patients, communities, and clinicians rather than financial imperatives. * Erin C. Fuse Brown, J.D., M.P.H., is a Professor of Health Services, Policy, and Practice at Brown University School of Public Health. ** Hayden Rooke-Ley, J.D., is a Senior Health Law and Policy Fellow at the Brown University School of Public Health. *** This article is based Erin Fuse Brown's remarks for the Stuart Rome Lecture for the Law & Health Care Program at the University of Maryland Francis King Carey School of Law on November 7, 2024, and we thank Diane Hoffmann and the faculty, staff, and students of the Law & Health Care Program. The authors acknowledge the helpful comments and feedback of Joseph Dov Bruch, Allison Hoffman, Victor Roy, Conrad Milhaupt, Elizabeth King, and Ana Santos Rutschman. The authors are grateful for terrific research assistance of Ayesha Rahim, Neil Mehta, and Natalie Svob. 1