"nothermark" <nothe...@not.here> wrote in message
news:9m6pbbd1vup6e9fda...@4ax.com...
> For profit and not for profit have the same issues with the insurance
> companies calling the shots over what they will pay for. My only beef
> with for profits is the cut they add over what a not for profit would
> want for the same service. The for profits have a couple of extra
> costs in both taxes and the shareholder returns. Setting payments to
> cover that runs up insurance costs.
Heh, heh, heh, I'm not in the mood for anything as silly as
discussing economics with Nattering Mark. I'm just tossing out this little
grenade strictly for amusement.
http://www.arbiternews.com/2014/04/08/why-nonprofits-are-the-most-profitable-hospitals-in-the-us/
WASHINGTON, April 8, 2014-Almost two thirds of hospitals in the U.S. are
nonprofit institutions. Given the significant tax breaks that come with
nonprofit status, in the healthcare context, nonprofit translates to massive
profits. Critics argue that coupled with the low level of charity some
nonprofits provide, in most cases tax breaks are unjustifiable and
unsustainable.
Of the country's thousands of hospitals, 23 percent are owned by governments
(state and local), 18 percent are for-profit and the rest are nonprofit,
according to the American Hospital Association (AHA).
Most people understand nonprofit hospitals as charity organizations that
provide free or discounted services for those who cannot afford to pay, and
as such, perform a necessary and valuable community service. However, in
reality U.S. nonprofit hospitals are extremely lucrative. At the same time,
many fail to provide the valuable services for which they get preferential
tax treatment.
The profitable nonprofit
In the U.S. healthcare industry, being nonprofit is more lucrative than
being for-profit.
"The 2,900 nonprofit hospitals across the country, which are exempt from
income taxes, actually end up averaging higher operating profit margins than
the 1,000 for-profit hospitals after the for-profit's income-tax obligations
are deducted," writes Steven Brill in his pioneering health exposé in Time
Magazine. "In health care, being nonprofit produces more profit."
To qualify as a nonprofit, hospitals must follow a number of rules including
having a written policy delineating how patients "in need of financial
assistance" will be treated, as well as a written policy explaining how
charges to patients are calculated. Under the Affordable Care Act (ACA),
hospitals will have to conduct a community needs assessment every three
years and develop strategies for meeting identified needs.
Nonprofit does not mean that the facility does not make any profits;
instead, it means that profits are reinvested in the hospital in the form of
new facilities and equipment, massive salaries and bonuses for nonmedical
administrators, expanding staff, offering more services and buying out
competing hostpitals and health systems.
There are currently no regulatory limits on hospital profits, including
nonprofits.
Considering nonprofit hospitals are exempt from local and state property
taxes as well as income and sales taxes, profits can be considerable. Add to
that the fact that nonprofits may also issue tax-exempt bonds, and nonprofit
hospitals are huge moneymakers.
The requirement that nonprofits reinvest in facilities and expand services
gives rise to huge hospital systems that virtually dominate host cities and
become the area's largest employer, with some hospitals bringing in more
revenue than what the host city collects in taxes and fees.
Another way for nonprofits to spend their profits is compensation, with top
administrator salaries in the millions of dollars. For example, in 2010 the
combined compensation of the top executives at the 25 most profitable
non-profit hospitals in the country totaled $59 million, according to Becker's
Hospital Review. The reported 2011 compensation for Jeffrey Romoff, head of
University of Pittsburgh Medical Center Presbyterian (the highest-grossing
nonprofit in the country) was $5.97 million.
The high wages do not stop at top-level administrators. A study by the
Bureau of Labor Statistics found that, on average, hourly workers get higher
wages in nonprofit hospitals than in for-profit ones.
"Payment of excessive compensation to executives, managers, and
administrators undermines the purposes of nonprofit corporations because it
results in fewer funds being available for their charitable purposes,"
concluded a 2013 study by the office of the attorney general in Sacramento,
California. "It is often the case that the hospitals, hospital groups, and
affiliated medical entities that pay the most excessive compensation also
provide less charitable care than comparable institutions that pay
reasonable compensation to their executives, managers, and administrators."
[snip]