2) Are the tax breaks justified? – Health care in America is a business. I don’t agree with that philosophically, but that is the present case. If nonprofit hospitals are supposed to provide a social benefit in exchange for tax-exempt status, what should be done when they pursue private patients and behave no differently than for-profit hospitals. For-profit hospitals DO see indigent patients without such tax breaks including one mentioned in the Chicago Tribune on the South Side. Why does U of C deserve tax-exempt status if the numbers (assuming they are correct) show only nominal amounts of charity care? Perhaps we limit or define what tax-exempt status means in a hospital setting.

3) Many nonprofit hospitals are cash cows – Anyone with eyes knows this. Balance sheets don’t lie. Last week, I spoke an economics student who worked at Univ. of Chicago who told me that whenever the hospital made a big profit, they would hide it by just paying the administrators more money (increasing expenses) to make it look less profitable than it is. Without inflation of hospital administrator salaries, the profit figures would look even bigger. Last night, an ex-pharm rep told me that Denver Children’s Hospital would skimp on neonatal treatments to keep more of their DRG payments (in this case by not giving the monoclonal antibodies that were covered under the DRG lump sum). I didn’t make this stuff up.
In business competition, nonprofit hospitals can use tax benefits to demolish for-profit competitors by investing in capital. I have heard complaints from private hospital administrators about this unfair competition.

4) Institution versus individual – Just because you, Brett, work for a questionable institution it doesn’t make you a bad person. Clearly you do a good job and treat your patients right. That doesn’t preclude the fact that you aren’t in control of what patients end up in your service. That’s a policy and administrator issue. Nothing in my post is to insult the very good work that nurses and doctors at these hospitals do. I question the larger institutions they work for and whether they have the right philosophy and policies behind them.

More points will follow.

Happy Holidays Schmuck!

Sincerely,

Someone who gets it……

Higher education privatization is an issue that also fascinates me; these teaching hospitals are also educational institutions as well, so it was indirectly about higher education as well. Maybe I’ll make that my thesis in London.

I never bought the line that “money is the root of all evil,” and it is always inherently corrupting. I always found that to be too Biblical and cynical for my tastes. I guess I was wrong.