There Is Little Charity In Wealthy Charitable Hospitals.

            The fat cat “charitable” hospitals, the ones with huge piles of cash, the ones who pay fortunes to their executives, have gotten to be fat cats by using certain strategies.  Now that antitrust enforcement has been in the garbage can for 28 years, they have merged like crazy and thereby gotten power over prices.  They charge list prices that are several times cost.  They focus on expensive procedures.  They engage in a form of arbitrage (which I always thought was illegal):  they issue tax exempt bonds and use the bond proceeds to buy securities that pay more than the hospitals are paying in interest on the tax exempt bonds.  They sell patients’ debts to tax collection companies -- who are great fun to deal with, right?  They sue the poor, who can’t pay, for their last nickel or the equivalent.  And -- just so you don’t forget -- who gets all the money?  Well, lots of it goes to the administrators, just like in for profit health insurance companies and just as with university presidents.  As the president of a true nonprofit hospital, and therefore a struggling nonprofit hospital, said to the Journal, “Nonprofit is a misnomer -- it’s nontaxable . . . . When you’re making hundreds of millions of dollars a year, how can you call yourself a not-for-profit?”

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            Last Saturday a great historian, Joseph Ellis, was at our law school for a four hour discussion of his terrific new book, American Creation.  The subjects that came up included the extent to which the founders were simply head and shoulders above the politicians, and the body politic, of our own day, and whether, if there were a true national conversation on the subject (and a plebiscite, I guess), Americans would choose to continue or to drop the imperialistic foreign policy we have so long and so disastrously indulged.  I think Joe Ellis may be more sanguine about some of these matters, and about America, than I am.  When I read pieces like the Journal’s long article about the so-called nonprofit, charitable hospitals, or about the greed and misconduct that are everyday matters, or about the warmongering that is a common style of our national politics, or about the ever renewing history of the wealthy screwing over the poor, or when I hear or see the constant imbecility that passes for political discussion among the pols, in the mainstream media and on lots of blogs, it is very depressing.  One wonders -- despairingly, to tell the truth -- whether we will ever have a decent society run on the private and public sides by honest, competent, fair minded people.  One wonders whether many of us who think, write and hope about these things are nothing but naifs, hopeless idealists, wasters of time and energy who foolishly can’t stop themselves from hoping for what is impossible in this country in this time -- or ever?

            The foregoing paragraph cries out for a stirring, hope inducing peroration, does it not?  I have none to offer.*

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