How many people are going to be able to come up with that kind of money up front??? Is there even a loan for such a thing? Short of selling your house, they are shifting all of the responsibility to the patient and taking all of the profit. I don’t pretend to understand how non profit hospitals differ from for profit hospitals, but if they get a tax deduction and special treatment they should be much more responsive to patients like these.
Alas, there are no simple answers, other than read your policies very carefully and don’t get sick. I hope they fix this mess before all of us baby boomers get older and sicker……

Here is the story Mr. Carlton references: http://www.truthout.org/issues_06/042808HA.shtml

Of course MD Anderson cannot confirm or deny anything without Ms. Kelly’s consent. Same goes for Ms. Sarkisyan at UCLA.

From the story it sounds like Ms. Kelly estimated her risk (she is a fairly wealthy woman) and got burned, but is still able to pay her medical bills.

Mr. Carlton wishes to force an institution with a large endowment to pay for all comers with medical problems and that is simply not feasible, especially for those with the funds to pay for their care.

The more I think about this the more I admire Ms. Kelly and her husband. They have plenty of money to pay off their debts right now but the more press they get, the bigger the discount MD Anderson will give them. It is great to know the art of negotiation is still alive in America. I am surprised the hospital did not immediately offer the customary discount of 15-25% they give insurance companies, but it sounds like with enough people like Mr. Carlton on their side the Kelly’s, who certainly aren’t wanting, will have all their bills waved.

Your proposal to tax not-for-profit hospitals is inherently self-defeating.

Like most other people, I expect fair value for my money, so why should I consider donating money to any organization that is losing its tax exempt status?

If the ignorant public would just go for Hillarycare, all these bad old problems would go away; right Doc?

Bob,

Nonprofit hospitals don’t rely on donations for funding. They make a profit on what they charge to provide care. But unlike for-profit hospitals, they’re not taxed on it. The tax exemptions are worth billions of dollars.

The real question is why nonprofit hospitals deserve tax exemptions more than for-profit hospitals or, for that matter, you. Traditionally, the response was that they provided benefits — care for the poor and the sick — that weren’t available any other way.

Now, you’d be hard pressed to tell the difference between nonprofit and for-profit hospitals from the way they look, the way they operate or what they pay their administrators. But the tax exemptions remain. Leaders at all levels of government are beginning to question whether they can still be justified.

Mr. Carlton,

By the way the first time I agreed with you was the about the designated hitter in your other post today.

Here, however, you are incorrect. There is an enormous difference between for-profit and not-for-profit hospitals. First, of course is that if you don’t have the money you will not be treated at a for-profit hospital. I’m not a hospital administrator, but I believe to maintain not-for-profit status, the hospital must donate a specific dollar amount of care (maybe 5% of the endowment they possess each year similar to universities). I am nearly certain Ms. Kelly would have been provided discounted or free care if it had been determined she was truly needy by MD Anderson.

As I posted previously, this is not the story to use for your argument. Ms. Kelly had and has plenty of money to pay for her care. She decided to purchase an insurance vehicle at $185/ month (she is 52). For reference, my mother, a non-smoker in good health and 53 years old purchased an insurance plan for $360/month while she was between jobs.

I do not believe the government should give preference to any person or organization based on what they do (or don’t do). That is not a function government should undertake. It should not give preference to the poor (government funded health care) at the expense of the wealthy nor should it give preferences to the wealthy (subsidies and tax benefits to large corporations) at the expense of anyone else.

I find it a perversion of morality that you would force MD Anderson to pay for Ms. Kelly’s care when she has the funds to pay for it herself. I would find MD Anderson morally culpable if she did not have the funds to pay, but I am not in the business of imposing my morals on anyone else, not even a rich hospital like MD Anderson. Apparently you are.

Your response Mr. Carlton?

John,

There is no national requirement that nonprofit hospitals provide a certain amount of charity care. Texas does have a state law that requires they provide 5 percent of operating revenues toward community benefit including charity care. Missouri and Illinois have no such requirement.

All hospitals — for-profit and nonprofit alike — are required to comply with a federal law called EMTALA (the Emergency Medical Treatment and Active Labor Act). Under it, they must provide immediate care necessary to sustain the lives of people in medical emergencies. That doesn’t include cancer care or care for any chronic condition. Nor does the law require full treatment, just that the patient be “stabilized” before being transferred.

Nothing in my post suggested that M.D. Anderson or any other nonprofit hospital be forced to absorb the full cost of treating Mrs. Kelly or any other patient. The question is why, if nonprofit hospitals operate exactly like for-profit hospitals, they should be exempt from taxes that for-profit hospitals (and newspapers and corporations) pay.

One last note, for what it’s worth: If you read the 1996 story about limited benefit health insurance policies I linked to, I think you’ll find that many of the people who buy them believe — and in some cases are explicitly told — that such policies are just like “regular” health insurance plans. Many people, perhaps even you, have absolutely no idea how much hospitals charge for a room each day. Some, even otherwise intelligent, hard-working people, hear the policy benefit of $250 or $300 a day and figure that’s plenty. When I was a little younger and knew much more about the world, I used to dismiss such people as fools. I’ve grown a lot more tolerant as I’ve gotten older. Maybe that’s because I’ve learned how easy it is, even with the best of intentions, to make a mistake.

Of course, that’s just me.

Mr. Deal, I can’t speak for Mr. Carlton, but a common argument about tax exemptions for non-profit organizations is that they are expenditures and amount to corporate subsidies. Of course that argument assumes that all wealth belongs to government to be collected and disbursed according to government dictates.

The other awkward argument is whether corporations should be taxed on revenues or on profits. If taxing revenues, there is no way around the fact the taxes are actually being levied on the consumer or patron as an embedded sales tax. If taxing profits, the exemptions are moot.

Sounds like a need for legislation for Congressman Bill next year, or better yet, Single Payer Medicare For All.