OK, let's unpack this. Welcome to the Deep Dive.
Our mission today is really laser focused on
one of the most powerful yet intensely scrutinized
entities in American health care, DaVita Inc.
That's right. This company specializes in a single
life or death service kidney dialysis and its
business model. Well, it provides a perfect high
stakes illustration of how health care, massive
corporate finance and government subsidies all
intersect. It's a deep dive into what is really
critical infrastructure. I mean, we are analyzing
a stack of sources here detailing DaVita's extraordinary
scale, its unique financial dependence on a highly
specific mix of government and commercial payers
and a decades long trail of high stakes legal
battles, settlements and regulatory scrutiny.
And the stakes here are just. They're profound,
they're personal, and they are non -negotiable.
We're talking about end -stage renal disease
or ESRD. Right. If you or someone you know faces
this diagnosis, the treatment kidney dialysis
is mandatory. It is not optional care you can
postpone or shop around for leisurely. No, absolutely
not. Patients require this life -sustaining intervention,
usually three times a week, for the rest of their
lives unless they receive a transplant. DaVita
is one of the dominant forces delivering this
care across the country. And that necessity,
that absolute medical need, creates a unique
market dynamic. I mean, when your survival literally
depends on a service, the providers of that service
hold incredible financial and political leverage.
So our discussion today is essentially about
how DaVita maximized that leverage within a system
where the government is the primary insurer,
but not the primary source of profit. That is
the core contradiction. The first hook that captures...
this tension perfectly, is the juxtaposition
of their corporate standing against their legal
woes. We are examining a company that hit, what,
U .S. $12 .8 billion in revenue in 2024? An incredible
number. And it's recognized as a component of
the S &P 500, meaning it's one of the 500 largest,
most robust public credit companies in the U
.S. A blue chip company by any definition. And
yet this blue chip giant is currently facing
multiple federal investigations and a major class
action lawsuit alleging market manipulation.
That is the core contradiction we need to dissect
for you. You have the stability and essential
service delivery on one side, and then on the
other, you have this pattern of aggressive financial
maneuvering and, well, significant legal risk.
To really understand the complexity, we have
to start with the sheer physical and financial
scale of DaVita. I mean, until you map out their
footprint, it's almost impossible to appreciate
how... fundamentally entwined they are with the
U .S. health care system. Let's define that footprint
first. The company is strategically incorporated
in Delaware, which is very common for large U
.S. corporations for legal and tax reasons. But
their operational headquarters are in Denver,
Colorado. OK, so that's the corporate structure.
Now let's look at the U .S. market dominance,
because our sources paint a very clear picture
of concentration. DaVita operates 2 ,675 outpatient
centers across the country. And that is a massive
network. It is. And this extensive network serves
200 ,000 to 1 ,800 patients. That 2 ,675 number
is, frankly, staggering. And here's why you should
care about that number. It indicates the accessibility
of their services. Dialysis is administered three
times a week. Right. You can't travel far for
it. You can't. Patients must have a clinic near
them. So by owning this many centers, DaVita
is effectively a local monopoly or duopoly in
thousands of communities across America. And
what does that mean for the overall market when
you have that kind of local concentration? It
means that DaVita holds a significant 30... percent
market share in the U .S. dialysis market. This
is where the structural issue of the entire dialysis
industry comes into sharp focus. So it's not
just DaVita. No. With DaVita holding 37 percent
and its main competitor, Fresenius Medical Care,
holding a similar share, you have a highly consolidated
duopoly dominating a non -elective life -sustaining
service. Wow. So roughly three quarters of all
U .S. dialysis patients are served by just two
companies. Exactly. Two. When we talk about monopolies
or duopolies in other sectors, you know, like
tech or logistics, consumers can eventually switch
or new services can be innovated. There's some
kind of market pressure. Right. There's an escape
valve. But in critical, mandatory medical care,
that level of concentration. It significantly
limits patient choice, which, as we'll see later,
provides enormous leverage for these companies.
Absolutely. And while the U .S. is their heartland,
their core business, they aren't purely a domestic
player. Their international reach, while it's
smaller in terms of revenue contribution, is
still pretty substantial. So what does that global
presence look like? While DaVita operates 367
outpatient centers and 11 other countries, serving
an additional 49 ,400 patients globally. This
international footprint demonstrates their operational
reach and, you know, it allows the company to
leverage efficiency and best practices across
different regulatory environments. But the main
event is the U .S. Oh, for sure. Their core regulatory
and financial challenges remain rooted right
here in the U .S. system. Let's pivot to the
corporate identity then and the hard financial
numbers from 2024. We already mentioned the US
$12 .8 billion in revenue. That level of revenue
dedicated to treating one single chronic condition
is just... It is. And when you look at the profitability
metrics, you see exactly why this company is
considered an institutional powerhouse. The 2024
financial snapshot, it reveals some serious operational
efficiency. Their operating income stood at US
$2 .09 billion and the net income was US $1 .25
billion. And for listeners who may be curious
about the difference there between operating
income and net income, operating income tells
you how much money the core business makes before
tax. So how efficient they are at running those
thousands of dialysis centers. Exactly. And net
income is the bottom line. What's left for the
shareholders after all expenses, taxes and interest
are paid. The fact that they retain over a billion
dollars in net income speaks to incredible discipline.
And that operational discipline is absolutely
necessary because structurally, DaVita is a capital
intensive organization. Their total assets are
valued at U .S. $17 .3 billion. 17 billion. That
figure underscores the enormous fixed cost base
required to run this whole operation. You have
to own or lease thousands of clinics. You have
to purchase and maintain millions of dollars
worth of specialized dialysis equipment. And
these are not simple machines. No, these are
complex, expensive medical devices. And you have
to manage extensive supply chains for dialysate
and pharmaceuticals. It's a huge logistical challenge.
That fixed cost base means they need volume and
they need reliable high margin revenue just to
cover that massive overhead, which brings us
to the human scale of it all. They employed 76
,000 people in 2024. Which cements their status
as a major US employer. And it earned them the
341st spot on the Fortune 500 list. And look,
when you hit the Fortune 500, you are a critical
part of the US economy. This leads us directly
to the major stakeholders, the institutional
investors who rely on this company's stability
and predictability. And here's where it gets
really interesting for anyone following high
finance. The massive shadow of Berkshire Hathaway.
Warren Buffett's investment vehicle is listed
as a major owner. The inclusion of Berkshire
Hathaway is in many ways the ultimate validation
of DeVita's business model. Buffett generally
seeks stable, predictable, long -term, profitable
businesses. And the non -cyclical, mandatory
nature of dialysis care fits that criteria perfectly.
People don't stop needing dialysis in a recession.
We found a fascinating little discrepancy in
our source material regarding that ownership
stake, which is worth discussing because it illustrates
the complexity of dealing with public corporate
data. Yeah, that was interesting. Our source
list. two slightly different figures for Berkshire
Hathaway's stake, 41 .2 % in the general information
box, but then 32 % in the detailed list of public
company ownership positions. And that difference,
it could stem from several factors. It could
be a difference in reporting dates. It could
be whether certain convertible shares are included
in one figure but not the other, or just how
different regulatory bodies categorize ownership.
But the key takeaway for you listening. Is not
the exact percentage. No, the point is the profound
significance. I mean, even at the lower figure
of 32 percent, a single entity, Berkshire Hathaway,
controls nearly a third of this multibillion
dollar life sustaining health care provider.
It's a huge stamp of confidence placed on a company
whose stability, as we are about to see, hinges
entirely on its ability to navigate the complex
and sometimes fraught financial gap between what
the government pays and what commercial insurers
pay. And that duality right there defines everything
DaVita is. If Section 1 was about who DaVita
is, this section is about how DaVita makes its
money. And this is the absolute financial core
of this entire deep dive. If you understand the
mechanics of the dynamics, you understand the
company's incentives, its strategies, and its
history of legal troubles. This is the critical
insight we really need to drive home for you.
Kidney dialysis is unlike many other medical
procedures because of a specific federal rule.
What's the rule? Medicare covers nearly all individuals
with end -stage renal disease, regardless of
their age, typically after a short waiting period.
This guarantees that most patients requiring
dialysis will have government coverage. Okay,
so the government is basically the default payer
for this condition. Let's put some numbers to
that. Our sources show for 2023, a staggering
89 % of DaVita's patients were covered by government
-based health insurance programs. So that's primarily
Medicare, but also some Medicaid. Nine out of
every 10 patients served by DaVita are relying
on the federal government to pay the bill. That
89 % represents volume and stability. It's predictable
revenue. It ensures that the lights stay on and
the expensive fixed costs we just discussed are
generally covered. However... There's always
a however. There is. When we look at the revenue
contribution breakdown for that same year, the
picture dramatically flips and it reveals the
real profit driver. Okay, let's see that flip.
So, while 89 % of patients were government covered,
those programs only accounted for 67 % of the
company's total revenue. Which means the remaining
11 % of patients, just that small slice covered
by commercial or private insurance, we're generating
the remaining 33 % of the company's total revenue.
Wow. That is a massive disproportion. It's huge.
So we have a small fraction of the patient population
generating one -third of the total revenue. But
here's the most important sentence in this entire
analysis, and this is according to our source
material. Those commercial payers. which accounted
for that remaining 33 % of revenues in 2023,
generate nearly all of the company's profit.
That is the engine. The volume, that 89 % government
segment, it covers the overhead and provides
the scale necessary for efficiency. But the profit,
the money that funds acquisitions, stock buybacks
and shareholder returns, which includes that
enormous Berkshire Hathaway stake, comes almost
entirely from that high margin commercial side.
We absolutely need to spend time on the why.
Why are commercial payers reimbursing DaVita
at such an astronomical disproportionate rate
compared to Medicare? The why comes down to a
simple concept fixed rates versus negotiation
leverage. Government payments from Medicare and
Medicaid are set through fixed, often bundled
rates determined by the Centers for Medicare
and Medicaid Services or CMS. These rates are
intentionally set low to control federal spending
and Vita has to accept them. Because of that
mandatory Medicare coverage rule. They have no
choice. Right. They are, on the government side,
a price taker. A price taker. Precisely. But
on the commercial side, DaVita is a price maker.
How so? Commercial payers reimburse DaVita at
a much higher rate because, remember, DaVita
and Fresenius control the market. It's that duopoly
we talked about. Since dialysis care is mandatory,
an insurer can't just tell its members, oh, sorry,
we won't cover treatment at the nearest DaVita
center. They have a riot on their hands. They
would. They must include the provider in their
network. And DaVita uses its massive footprint
to negotiate extremely high rates, sometimes
hundreds of percent higher than the Medicare
rate for the exact same service in the exact
same chair with the exact same technician. So
this high commercial rate isn't just padding.
It's structural to their entire business. If
DaVita lost its high -margin commercial business,
the company would likely cease to be profitable,
regardless of the steady stream of government
patience. Absolutely. It creates an existential
imperative for the company to attract and retain
commercially insured patients. It explains every
strategic move we're about to discuss. It explains
the imperative for ruthless efficiency to squeeze
every penny out of the government side. And crucially,
it explains the legal history. As you'll see,
any alleged fraud or kickback scheme can often
be traced back to the drive to capture, retain
or maximize payments from that highly valuable,
high margin commercial slice of the pie. So the
goal is volume, yes. But the profit driver is
optimizing the payer mix, getting those commercially
insured patients onto the dialysis chairs at
the Vita centers. That insight is essential to
carry forward. It's the key to the whole story.
And that financial structure didn't just appear
overnight. It's the result of decades of massive
corporate pivots, high -risk financial engineering,
and near -catastrophic failures. Let's trace
how this US $12 .8 billion entity got here, starting
with its inception. The company was established
relatively far back in 1979. Initially, it was
called Medical Ambulatory Care, Inc. And crucially,
it was born as a subsidiary of a much larger
parent company, National Medical Enterprises,
Inc. Which later evolved into Tenet Healthcare,
as you mentioned earlier. Right. So this gave
it established resources and roots from day one.
It wasn't just a startup. But the first major
financial shockwave came in 1994. And it wasn't
through organic growth, but through high stakes
financial maneuvering. The Leverage Buyout, or
LBO. In August 1994, 70 % of the company was
acquired by DLJ Merchant Banking Partners. An
LBO is essentially buying a company primarily
using debt, expecting the company's future cash
flow to pay off that debt. It's a high -risk,
high -reward move. And the total value of the
deal was $75 .5 million. But what was DLJ's actual
skin in the game? That's the amazing part. Their
initial equity investment was surprisingly small.
just $10 .5 million. They were betting big on
the company's future using mostly borrowed money.
And following the LBO, they renamed it Total
Renal Care Holdings, Inc. The clock immediately
started ticking for the investors. I mean, LBO
firms typically look for a quick exit to monetize
their investment, and Total Renal Care wasted
no time. Exactly. They turned it into a public
company just over a year later. The initial public
offering, the IPO, happened in October 1995 and
successfully raised $107 million. This infusion
of cash allowed the company to pay down some
of that LBO debt and provided the investors their
first real opportunity to cash out. And the investor
payoff for DLJ was just spectacular. By December
1996, our sources show that DLJ had made a stunning
386 % return on its initial $10 .5 million investment.
Just think about what that means. You're turning
$10 .5 million into over $40 million in just
two years. That level of rapid, high -margin
financial success in the healthcare space sets
an extremely aggressive precedent for future
leadership. It builds an expectation. It creates
a culture of expectation for exponential growth,
and often that expectation drives leaders to
make really aggressive moves that can lead to
instability, which is precisely what happened
in the late 1990s. They ran straight into a massive
corporate crisis following an acquisition headache.
In February 1998, they acquired a major rival,
Renal Treatment Centers, for $1 .3 billion in
stock. This was supposed to be a market -defining
merger, the big move to consolidate power. Instead,
it turned into what you could call corporate
indigestion. The sources are very clear. The
integration of this massive acquisition went
poorly. And look, combining two large, geographically
dispersed health care providers is always difficult.
You're trying to harmonize IT systems, clinical
protocols, corporate cultures. It's a nightmare.
And this failure led directly to chaos at the
top, resulting in the simultaneous resignation
of the CEO and the CFO in July 1999. That's a
huge red flag for the market. The market reacted
immediately and harshly. The stock, which had
tripled in value between the 1995 IPO and 1998,
just collapsed. By July 1999, it had dropped
71 % year to date. This was a near -death experience,
a full -blown financial crisis for the organization
then known as Total Renal Care. They were on
the brink. So to stabilize the failing company,
the board brought in new leadership. Ken Cheturi,
who was 43 at the time, was named CEO in October
1999. His initial task wasn't growth. It was
survival and radical internal overhaul. He had
to stop the bleeding. This turnaround effort
culminated in the company's symbolic rebirth.
In 2000, they shed the ballast of the failing
acquisition integration, they sold off their
non -U .S. operations to Focus, and they renamed
the company DaVita Inc. And the rebranding itself
was strategic and, frankly, brilliant. The name
DaVita is derived from the Italian phrase der
vita, which means to give life. It was a very
conscious effort to move past the financial failures
and the stock collapse associated with the total
renal care name and recenter the company's identity
around its noble, life -sustaining mission. A
fresh start. Following that stabilization, the
next decade saw a return to that aggressive growth
by acquisition strategy. The focus was on market
share dominance, which made them the giant they
are today. The first major post -rebirth acquisition
was Gambro Healthcare in October 2005. That was
a crucial move to solidify their U .S. market
position against Phrygianus, but they weren't
done trying to expand their scope. Then came
what we termed the medical group experiment.
In 2012, DaVita acquired healthcare partners
for a massive $4 .42 billion. They later rebranded
this entire division as DaVita Medical Group
in 2016, and the strategic goal was clear. By
owning primary care, specialty care, and urgent
care groups, they could potentially control the
referral streams of ESRD patients directly to
their high -margin dialysis centers. It was an
attempt at vertical integration, controlling
the patient journey from the moment of diagnosis
all the way to treatment. But managing massive
decentralized physician practices is a whole
different ballgame from running efficient standardized
dialysis centers. And the experiment, well, it
didn't last. By 2019, they performed a major
strategic pivot. selling the entire DaVita Medical
Group division to UnitedHealth Group's Optum
division for $4 .3 billion. And what's so fascinating
here is the financial outcome. They walked away
from this multi -billion dollar strategic pivot
and they essentially recouped the entire initial
investment. They basically got their money back.
They did. It demonstrates incredible financial
savvy in their exit strategy. They realized the
core business was dialysis. They jettisoned the
distraction without a significant loss and they
immediately refocused resources on their core
profit drivers. And that focus led to a steady
stream of smaller, more strategic acquisitions
that demonstrated a consistent... expansion strategy
in specific high growth or high value regions.
We see clear examples of this focus regional
strategy. In 2014, they acquired Colorado Springs
Health Partners, integrating 600 employees and
110 ,000 patients into their ecosystem. And then
in 2016. In 2016, they picked up the Everett
Clinic Medical Group, a huge practice in the
Seattle area, with 20 sites and 315 ,000 patients
for $385 million. And then again in 2017, they
acquired Well Health Quality Care. So these regional
expansions, they highlight a strategy of buying
up the local competition and, more importantly,
key referral sources. It's this decades -long
persistent drive for market consolidation that
leads us directly to the enormous price the company
has paid in legal settlements and regulatory
actions. The growth had consequences. If section
two explained the motive, that relentless chase
for the high margin commercial patient, this
section illustrates the consequences. The history
of DaVita is marked by a clear and expensive
pattern of settling very serious allegations
of fraud and misconduct, underscoring the high
stakes environment of subsidized health care.
Let's start with one of the biggest initial hits.
The illegal kickbacks case in 2014. DaVita agreed
to pay a massive $350 million settlement. So
to connect this back to the core business model
we talked about, why would a dialysis provider
pay kickbacks? For the patients. For the right
patients. Because the commercially insured patients
are the ones who generate all the profit. The
allegation was that DaVita provided illegal financial
incentives to doctors to ensure those highly
valuable patient referrals were directed specifically
to DaVita's centers, keeping them out of the
hands of competitors. So a $350 million penalty
is really just the cost of doing business when
you are aggressively protecting that critical
11 % of your payer mix. You could certainly see
it that way. The very next year, 2015, brought
an even larger settlement concerning drug waste
and billing fraud. DaVita agreed to pay $450
million for this one. This case highlighted systemic
fraud aimed specifically at the government system,
at Medicare. The allegation involved seeking
reimbursement from the U .S. federal government
for drugs that were unnecessarily disposed of.
How does that work? Well, many drugs used in
dialysis, like those for anemia, come in multidose
vials. So if a doctor uses only a fraction of
the drug from a vial on one patient, the remaining
drug often has to be discarded for safety reasons.
DeVito was accused of billing Medicare for the
entire vial multiple times. So they'd use a little
on one patient, bill for the whole thing, use
a little more on another patient, bill for the
whole thing again. They were maximizing payment
by essentially turning necessary waste into a
systematic revenue stream. A $450 million settlement
indicates this practice was probably widespread
and longstanding. Here's where the focus shifts
from financial fraud to patient safety, bringing
the human stakes back into sharp focus. In 2018,
DaVita faced devastating wrongful death claims,
and this resulted in a jury awarding $383 million
to the families of three patients. This case
centered on the ultimate failure of care quality.
The patients tragically died from cardiac arrest
after receiving treatment at DaVita centers.
And while the legal specifics are complex, the
verdict suggests that cost -cutting measures
or operational lapses. Driven by that intense
need for efficiency we talked about. Exactly.
Driven by the need to make the low margin government
segment work. May have had catastrophic consequences
for patient safety. This massive award is a stark
reminder that in health care, efficiency cannot
come at the expense of quality. Also in 2018,
we saw another major False Claims Act violation.
This one focused on inflated payments settled
for $270 million. And this one touches on a specific
mechanism of fraud related to Medicare Advantage
plans. This is a complex but really crucial area
known as risk adjustment coding or upcoding.
Explain that. So Medicare Advantage plans are
run by private insurers, but they're funded by
the government. And they receive higher federal
payments for patients who are deemed sicker or
more complex, those with higher risk scores.
The allegation was that DaVita provided inaccurate
information, essentially exaggerating the severity
or complexity of patients' conditions. Which
made the patients look sicker on paper than they
were. Right. And this caused the Medicare Advantage
plans to receive inflated payments from the government,
which in turn allowed DeVita to charge those
plans higher rates. It's a roundabout way to
get more money from this system. The $270 million
settlement proves the government views these
inflated coding practices as a clear violation
of the False Claims Act. And there's a specific
fascinating detail here that illustrates the
power of federal law. The whistleblower. Exactly.
The whistleblower, a man named James Swobin,
who brought the initial action, received a bounty
of $10 million for exposing the scheme. That
payout shows the scale and value of the information
he provided to the government. It's a huge incentive
for insiders to come forward. Moving into the
2020s, the legal scrutiny shifted a bit, from
billing Medicare to labor market practices and
antitrust concerns, reflecting DeVita's increasing
market power. In July 2021, a federal grand jury
indicted DeVita and former CEO Kent Thury. The
same CEO who had led the company's rebirth after
the crisis. It's the very same one. They were
indicted on charges of labor market collusion.
What was the allegation there? The allegation
was that DaVita engaged in no poach agreements.
So conspiracies with a competitor, surgical care
affiliates to suppress competition for the services
of certain senior level employees. So they agreed
not to hire each other's executives. Essentially,
yes. And these kinds of conspiracies stifle wage
growth and employee mobility. While it's not
related to patient fraud, it shows regulatory
bodies are scrutinizing every lever DeVita pulls
to maintain profitability and control costs,
including those related to its 76 ,000 employees.
There's a major win for the company here, though.
This one didn't end in a settlement. That's right.
Despite the federal indictment, both the company
and Thurry were acquitted by a jury in April
2022. This really demonstrates the challenge
the government faces improving these complex,
white -collar, anti -collusion cases beyond a
reasonable doubt, even with extensive evidence.
But the regulatory pressure from the Federal
Trade Commission, the FTC, it didn't let up.
They focused squarely on DeVita's long -term
strategy of aggressive regional consolidation.
Right. In 2021, the FTC imposed strict limits
on the company engaging in future mergers, specifically
in the state of Utah. Why Utah? This was a direct
regulatory response to the strategy we saw laid
out in Section 3, buying up local and regional
competitors. The FTC determined that DaVita had
become too dominant in the Utah markets through
these acquisitions, effectively stifling competition
and giving them undue pricing power. The FTC
is now actively regulating DaVita's ability to
grow through acquisitions in regions where its
market share is already just too high. And this
leads us to the present moment, marked by a massive
intensification of scrutiny focused on the duopoly
structure itself. In 2024, the FTC began investigating
DaVita, along with its rival, Fresenius Medical
Care. The allegation is that the two companies
are using illegal tactics to push smaller dialysis
companies out of the market. This probe is critical
because it challenges the very structural foundation
of the U .S. dialysis industry. And finally,
the most recent development from May 2025 ties
all of this legal history, the collusion, the
duopoly, and the profit imperative into a single
massive proposed class action lawsuit. This lawsuit
was filed by the Benefits Fund of the United
Food and Commercial Workers Local 1776, and it
targets both DeVita and Fresenius. The core allegation
is simple. The two dominant companies illegally
conspired to inflate treatment costs for dialysis
patients by billions of dollars. So if that allegation
is proven, it confirms the direct link we established
back in Section 2. It does. That small percentage
of commercial revenue is critical for profit.
If the two market leaders colluded to keep those
commercial reimbursement rates artificially high,
then the multi -billion dollar cost of that high
margin profit slice is ultimately borne by private
payers, by benefits funds, and indirectly by
the employers and union members who fund them.
When you total up just the key settlements and
verdicts we've covered, $350 million, $450 million,
$383 million, $283 million, you are looking at
well over $1 .4 billion paid out in recent years
alone. Over a billion dollars. That figure, combined
with the ongoing antitrust scrutiny, paints a
clear picture of a company whose necessary life
-saving service is constantly intertwined with
major financial and legal risk. So what does
this all mean? Our deep dive into DaVita Inc.
has truly synthesized the critical tension at
the heart of essential American health care.
It really has. On one side, you have a massive,
highly efficient S &P 500 company providing a
non -negotiable, life -sustaining medical treatment
kidney dialysis to over 200 ,000 people. This
is indispensable service delivery. You can't
argue with that. It's necessary. But on the other
side, you have a financial model reliant on leveraging
the vast disparity between low fixed government
payments and astronomically high negotiated commercial
payments. And that pursuit of disproportionate
profit has repeatedly fueled aggressive strategals,
resulting in billions in settlements for issues
ranging from illegal kickbacks and inflated billing
to devastating wrongful death claims. The history
we traced, the LBO, the collapse, the rebirth
as DeVita, the massive acquisitions and the successful
divestitures. It all shows a corporate entity
that is relentlessly optimizing itself to extract
maximum value from a fixed -demand, subsidized
market. Exactly. And this brings us back to the
present, focusing on that 2025 class action lawsuit
and the ongoing FTC probe into the duopoly shared
with Fresenius. These actions directly target
the alleged conspiracy to inflate those high
margin commercial rates. This raises an important
question for you, the person listening, trying
to be well informed. When two dominant companies
with DaVita alone holding 37 percent of the U
.S. market are repeatedly accused of financial
misconduct. and are under investigation for allegedly
conspiring to inflate costs for mandatory life
-saving care. What does that suggest about the
true function and future accessibility of critical
medical services in the United States? When the
structure of the market ensures that profit comes
not from serving the majority of patients covered
by the government but from maximizing the yield
from the few covered by private money. Well,
that tension creates a perpetual regulatory environment.
And it forces us to consider whether the concentration
of essential care in the hands of these hyper
-profitable corporate entities can ever be fully
divorced from financial strategies that push
the legal and ethical boundaries. It's a complex
and high -stakes system. And understanding the
financial dynamics is really the key to understanding
the headlines. Something for you to mull over
the next time you hear about health care regulation
or private insurance premiums. A deep dive into
the business of giving life. And the cost of
profit. Thank you for joining us. We'll see you
next time.