I've learned that the term "non-profit" encompasses an extremely wide range of organizations- many are true to the name but many are predatory or even borderline fraudulent. The reasoning behind non-profit hospitals goes (and please do jump in and correct me if I'm wrong) that they still have to cover their operating costs- pay their doctors, nurses, administrators, pay the light bill, drug and materials costs, blah blah blah. Because of this, that means they still have to take in money from paying customers. So, that means that only a certain percentage of patients they see don't have to pay, or pay very little. This means that some organizations will only see the absolute bare minimum number of patients at little or no charge to fall into the "non-profit" category, or even fudge the numbers, or only decide that patients who come in with a superficial cut or sprain will be seen at no charge while anyone with a more serious and more expensive condition will pay. A lot of "non-profits" actually do turn a profit, but they can't technically declare it as such. So, with the surplus money they bring in they use to open up another "non-profit" hospital or find a way through tax write-offs or inflated payrolls to essentially, funnel the actual profits in such a way that they can make it look like they're barely breaking even.
A very progressive friend of mine from college pointed me toward this article from the wall street journal which essentially outlines exactly what you assert here.
http://www.wsbt.com/news/consumer/17296354.html
And then, there are non-profits that truly are exactly that and should be commended for their selfless contribution to society and humanity in general. The problem then becomes, how can you tell who is doing the right thing and who is playing the system?
How can you tell? There are protocols in place with the IRS to flag/penalize offenders.
The reality is, the wording of the law is so vague there is a LOT of wiggle room. Nonprofits by law are prohibited from distributing surplus revenues to individuals. That’s it. And anyone who can define their organization as in the “public’s good” can be given 501(c)(3) status (tax exempt).
It doesn’t matter what I (a citizen) believes is the intent of the law. What matters is how our gov and courts interpret it. And its all so vague...well, wiggle room.
Gov wrote the law and monitors the non-profits. These organizations (which are allegedly corrupt) stay in business for one of two reasons. Either the gov understands the problem and is ok with it, or the gov has no idea how to fix it.
People can get angry at non-profits all they want but in many cases they are not breaking the law, they are operating within the boundaries set by the gov. I submit the beef should be with the gov.
So, when Obama says that much will be turned over to non-profit hospitals, the question then is raised as to what KIND of non-profits will they be and who will be making sure they play fair?
We’ve already established the gov is either complicit or incompetent when it comes to non-profits operating outside of the intent of the law. We also know the gov admits to extensive waste and abuse in the two other medical systems it manages.
I don’t know if any organization is up to the task frankly since there seems to be corruption everywhere humans actually manage....heh.
Ironically……..most large non-profits are run by public administrators. Meaning they acquire the same degrees and certificates as public managers/administrators that work in local/state/fed gov. Running the FDA and running a large not for profit hospital…as far as education and legislative/policy experience go… is pretty much the same. In short, these professionals are all coming out of the same bureaucratic pool.
I think it would be a WHOLE lot easier to try and address it locally first. Give people tax credits and breaks, let them cross state lines, maybe use people's tax returns to do things like set up health savings plans, open clinics like here in Dayton (AND ADVERTISE THEM!)
The Dayton Daily News TODAY has a story on the front page about a man in Washington Township. The man thinks he has cancer again and no insurance so he can’t be treated.
Except he can and based solely on his income at one of several local not for profit clinics.
If I were cynical I might believe the DDN first paged that story because they want to support Obama and its dramatic.
If I give them the benefit of the doubt, I might believe they don’t know about the vast array of free services and clinics available in the city. (Which is likely since the paper is no longer even located in the city.)
More likely it was both. But in the end that man will want Obama’s plan because he is not informed about what is available less than 10 miles from his own front door.
(When I asked an official about this lack of advertising I was told some law (maybe its just Ohio, I don’t know) says they can’t use any money for advertising. And since these not for profits don’t have a good relationship with the media for whatever reason (mostly because they want free advertising is my guess) few people (usually those who seek some type of aid/welfare where this info is on tap at the front door...) know about them.
Now that is more information than you ever cared to read about Dayton I'm sure. Heh.
