tag:blogger.com,1999:blog-32053362.post7454432413793711717..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: Is "non-profit business" an oxymoron?Paul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-32053362.post-50283215165667264942010-11-03T10:36:40.637-04:002010-11-03T10:36:40.637-04:00The whole system is corrupted by multiple prices f...The whole system is corrupted by multiple prices for the same service based on your method of payment. Why is it that self pay patients pay almost double the amount of a traditional insured patient? The answer: The non-profit hospital writes off the inflated cost as "charity" then bills for the actual cost.<br /><br />This is not including the "cherrypicking" of lucrative insurance billing to the for-profit branch of the same company. They "out-source" to themselves to the for-profit side, but maintain the ability to write off the undesirable accounts on the non profit side. (example: medical supply, linen, surgery centers, pharmacy, home health ect...)jarkarsenoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-28729401160232003602010-08-10T21:11:30.412-04:002010-08-10T21:11:30.412-04:00I run a small independent pharmacy in Muskegon, Mi...I run a small independent pharmacy in Muskegon, Michigan. My main competition is not Walgreens, but our local non-profit hospital. This hospital has set up 7 pharmacies in our medium size town. They also have a home health equipment company, a hearing aid company, and they own a vast majority of the physician offices.<br /><br />If the non profit hospital provides a unique service for the community, then I think most citizens would approve. But if the hospital is merely setting up competing businesses where the service is already well provided by the private sector, then the community has every right to question both the legality and the motives of that hospital.<br /><br />With the hospital owning and controlling the vast majority of the communities medical assets, what can I do other than complain?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-72996186514206997252010-03-20T21:05:32.198-04:002010-03-20T21:05:32.198-04:00The definition of non-profit to my understanding i...The definition of non-profit to my understanding is that all profits are put back into the hospital. I do not think that means giving bonuses of any kind. Non-profit hospital administration and managers should be paid a salary based on their job duties, not based on profits made. That is the definition of a "for-profit" company, correct? The "for profit" administrative salaries should be tied to the amount of profits made. <br /><br />There definitely needs to be major reform when it comes to non-profit status. I work for a hospital and we owned and employed many of our local physician offices in the area. The doctors' pay was based on how much money their offices brought in, until recently. The non-profit hospital just figured out it was against federal regulations to pay them this way. You think?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-12130080214501373082008-11-01T14:09:00.000-04:002008-11-01T14:09:00.000-04:00I appreciated the comments made by "Anonymous" on ...I appreciated the comments made by "Anonymous" on April 9th. I sit on the other side of this proverbial fence. <BR/><BR/>As an administrator in a hospital that receives one of the largest federal contributions for providing care to the indigent, I've lived through both lean years and times of great profit. Last year my organization realized a 40 million dollar profit. With these monies we openened a for-profit entity, a rural non-profit entity, and, yes, gave several chief administrators large bonuses (I was not one of these).<BR/><BR/>In comparison, this year, we are looking to close the year 50 million dollars in the red. The reasons for this are economic, refusal by our state's goverment to reimburse due to their own financial issues, and regulatory. In response--cheif administrators (those same ones who received large bonuses) took a 5% pay cut, then a 10% pay cut, and will likely be asked to take a 15% pay cut before the end of the year. The CEO of my organization has shown her commitment by returning her salary to the organization.<BR/><BR/>So, I guess what I'm trying to say is that its easy to throw stones at non-profit entities when the money is flowing. Don't, however, fail to recognize the commitment to the charitable goal and to lower staff members by top administrators when times are lean. This is not the first time I've seen my superiors dig deeply in their own financial pockets in order to protect lower-paid individuals in the organization.<BR/><BR/>This is also why I have stayed with this organization earning %50 percent less than I could earn elsewhere. Each time I see my bosses give so selflessly (and I've seen it many times)I renew my own commitment. And, when we have highly profitable years and my superiors give themselves large bonuses, I don't begrudge them this.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-87557691000930077372008-10-05T10:34:00.000-04:002008-10-05T10:34:00.000-04:00Transparency will win out and the label of "non-pr...Transparency will win out and the label of "non-profit" will be exposed for what it is. Just like the meltdown on Wall Street, which I call a Karma Correction, all of the greed will be revealed, and the excuses for the greed will fall on deaf ears (at long last)!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-51075608389418001552008-10-05T10:26:00.000-04:002008-10-05T10:26:00.000-04:00The increasing transparency of non-profits' and th...The increasing transparency of non-profits' and that their status is, indeed, an oxymoron....because so many of us have been victimized by this facade...will find themselves going the way of Wall Street..and just watch the scramble as they try to squeeze the last drop of blood out of us before they go down with a Single-Payer System. Claiming that there are enhanced/better services provided for by the non-profit status is just one of the diversions we have been fed. Mark my words, the list of those whose greediness benefited by the smoke-screen of being called a non-profit will be published for all to see. You can run but you cannot hide, and whoever wins this election will have be on board to expose this greed (hopefully before we go to the polls so we can make a quicker recovery after the fact). Unlike Wall Street, we will not bail you out because that would be the ultimate "double dip", now wouldn't it.it'smehttps://www.blogger.com/profile/00202511090182198997noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-56231921511555928502008-04-09T20:56:00.000-04:002008-04-09T20:56:00.000-04:00I work at a not for profit hospital in NJ where th...I work at a not for profit hospital in NJ where there was a strike in 2006 because the hospital refused to give the RNs a new Health insurance package that was far superior to the one offered by the hospital and would have saved the hospital half a million dollars. I suspected at the time that the reason for the hospital refusing the new money saving plan was that they were including all the employees in their Charity Care pool. After reading the April 4th, 2008 WSJ article I am convinced of this fact.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-35884480603552307232008-04-09T15:23:00.000-04:002008-04-09T15:23:00.000-04:00There are some interesting comments on this subjec...There are some interesting comments on this subject also on The Health Care Blog; the post is a few days old. I abstracted one comment from "mpk" below (with apologies to mpk; hope doing this is "legal"):<BR/><BR/>"Our local "non-profit" hospital was $40 million in the black last year. It also received almost $25 million in state and federal grants because of it's non-profit status and the fact that they have to handle some illegal immigrants in their ER. However,it paid no taxes. My neighbor is the CFO of one of the subsidiaries this Hospital and he just got his $200,000 BONUS at the beginning of the month. He's 33 years old, knows nothing other than massive salaries and profits for himself and is very happy the state and federal gov't are giving them millions in grants and "aid" while the execs strip out millions for themselves."<BR/><BR/>I have similar experience, both at my local hospital and the hospital system at which I used to practice - I don't think it's as uncommon as you think, Paul.<BR/><BR/>Another commenter had an interesting idea - make the "rich" nonprofit hospitals subsidize the "poor" ones - e.g. if you aren't in a location where you have to provide much charity care, then contribute $$ toward those that have much higher charity care rates.<BR/><BR/>But here's the crux: "them's the rules" for nonprofits, and the rules are poorly defined, so naturally some hospitals are going to play the rules to their benefit - just like some churches, some colleges, the American Red Cross, and many other nonprofits. <BR/><BR/>The key is, the rules for qualifying and operating as a nonprofit organization, be it a hospital or anything else, need to be MUCH better defined by the feds. Else we taxpayers are going to continue massive subsidies to businesses who are abusing their nonprofit status.<BR/><BR/>nonlocal MDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-7736332309778168282008-04-09T11:22:00.000-04:002008-04-09T11:22:00.000-04:00I think Academic Medical Centers are unique becaus...I think Academic Medical Centers are unique because of their teaching and research functions. As a patient or a payer, I think it would be more interesting to compare, say, a for profit community hospital vs. a non-profit. Assuming there are not significant differences in uncompensated care, how do the cost structures and the pricing for like services compare? Are for profits more efficient? Can non-profits charge less because they don’t have to make a profit or answer to shareholders? With 85% of hospital beds nationwide controlled by non-profit institutions and for profits virtually non-existent throughout the Northeast, I don’t think non-profits deserve very high marks for either efficiency or their ability to control costs over the long term. That said, there is no question that all hospitals have to at least cover their costs in order to stay in business.<BR/><BR/>I think it would be more productive if we keep pushing for greater transparency around both pricing and quality. I would like to see some adverse consequences for hospitals and doctors who persistently treat patients more aggressively than peer institutions elsewhere with no difference in outcomes to show for it. Bundled pricing for expensive surgical procedures would also be helpful, but doctors and hospitals would actually have to work together to bring that about. Perhaps grouping hospitals and doctors into tiers like drugs are now could help to steer patients to those providers that deliver high quality care at a reasonable cost. If patients and referring doctors know who the most cost-effective providers are, the less efficient might be forced to improve or lose business which is the way it should be.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-79536102460315307652008-04-09T00:09:00.000-04:002008-04-09T00:09:00.000-04:00But when I see "non-profit" Blue Cross/Blue Shield...But when I see "non-profit" Blue Cross/Blue Shield giving their CEO a $16M retirement package while he still holds a $multi-million paying position at the company, the wsj commenters have very valid points. Doubly so when my premiums go up 20%, 30% or more every year (up 50% this year alone).<BR/><BR/>And before you correct me, you said "non-profit business" not "non-profit hospital", although I think such distinctions are irrelevant. I'm the one who ends up paying for both.Anonymousnoreply@blogger.com