> now the VC lends the money from the bank, buys the clinic, and here's the important part: _they push the debt onto the clinic's books

This mostly correctly describes a leveraged buyout (LBO). LBOs are done by LBO shops, a type of private equity (PE) firm. Not VCs. (VCS do venture capital, a different type of PE.) And LBO debt isn’t “pushed” onto the company’s books, it’s never on the sponsor’s (LBO shop’s) books in the first place to any material extent.

Private credit, on the other hand, involves e.g. Blue Owl borrowing from a bank to lend to software businesses, usually without any taking control or equity. It’s fundamentally different from both LBOs and VC or any private equity inasmuch as it doesn’t have anything to do with the equity, just the debt. (Though some private credit firms will turn around and lend into a merger or LBO. And I’m sure some of them get equity kickers. But in that capacity they’re competing with banks. Not PE. Certainly not VC, though growth capital muddles the line between what is VC and other kinds of PE or even project financing.)

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codethief 5 hours ago | parent | next [-]

> And LBO debt isn’t “pushed” onto the company’s books, it’s never on the sponsor’s (LBO shop’s) books in the first place to any material extent.

Doesn't the LBO shop still need to pay off the debt, technically speaking? AFAIU the company's assets (hospital in OP's example) are used as collateral in a credit agreement between the LBO shop (as the hospital's new shareholder) and the bank. But unless I'm mistaken, this is not exactly the same as the debt being on the hospital's books and the hospital having a credit agreement with the bank. (For an increase in debt on the liabilities side of the balance sheet there would have to be an equal increase of assets on the other side. The hospital didn't receive the cash, though, nor does the hospital suddenly own itself.)

	▲	4 hours ago \| parent [-]
		[deleted]

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mbesto 6 hours ago | parent | prev | next [-]

Guy who works in the PE market here (not a PE shop myself) - this comment is correct.

	▲	meetingthrower 4 hours ago \| parent \| next [-]
		Correct. One niggle in that PE can access private credit as part of the capital stack. One flavor of debt in the ice cream store.
	▲	refurb 22 minutes ago \| parent \| prev [-]
		If you work in a PE shop you’d know it’s not riskfree and that the PE firm also puts their own money up plus money raised through LPs (hence “leveraged”)

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csa 3 hours ago | parent | prev | next [-]

> And LBO debt isn’t “pushed” onto the company’s books, it’s never on the sponsor’s (LBO shop’s) books in the first place to any material extent.

Could you please explain the how and why of the mechanics of this process (edit: from the perspective of the lender)?

It seems like the lender is taking a massive sucker bet.

Or is the reality that the lender gets repaid the vast majority of the time, and we only hear about the bad outcomes?

	▲	Tuna-Fish 3 hours ago \| parent \| next [-]
		The lender generally has a positive EV, but variability is high. The interest rates on leveraged buyouts are high, and the lender has priority over everything but taxes. If the company can stay afloat for a while, the lender probably got made whole and then some, even if the full loan never got paid back.
	▲	mathattack 3 hours ago \| parent \| prev \| next [-]
		Any one loan may be risky, but in aggregate the rates compensate for it. They pay you 0-4% for the money in your checking account and lend it at 1-3% points higher. As long as they have a big enough uncorrelated portfolio, they make easy money. And if the whole portfolio tanks all at once, the whole industry gets bailed out.
	▲	3 hours ago \| parent \| prev \| next [-]
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	▲	s1artibartfast 3 hours ago \| parent \| prev [-]
		The latter. Big Banks lend to private equity because the profit is good and they are large enough to absorb the variability. The public hates it because they see highly visible bankruptcies. They don't see the success stories, or the businesses successfully carved up for more value than the sum of their parts

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gowld 6 hours ago | parent | prev [-]

Why does Blue Owl borrow from a bank to lend? Why would it need investors if it borrows from a bank?

	▲	JumpCrisscross 5 hours ago \| parent [-]
		> Why does Blue Owl borrow from a bank to lend? Why would it need investors if it borrows from a bank? Leverage. They raise money in their public funds. And then they borrow, typically around 50% of their capital, to amplify returns. Note: “Private credit lenders won’t lose money before private equity firms do. That’s how the capital stack of companies work: Equity is the first in line for losses. Before lenders like Apollo Global Management, Blue Owl Capital or Ares Management lose a dollar on their loans if a portfolio company fails, the private equity owners will already have been hit” [1]. Leveraging the senior debt is actually less risky than leveraging the underlying equity. (Though obviously they compound when done together.) [1] https://www.nytimes.com/2026/03/12/business/dealbook/private...