Saturday, August 25, 2007

St. Elsewhere

I was throwing out an old Wall Street Journal from July 20 this morning when I saw an article that I had missed and that I wanted to post about. The title is "Nonprofit Hospitals Scrutinized on Care to Needy" by Theo Francis. The article speaks to Doug's posts about models of non-profit compassion and to my frequent references to the corrosive effects of Christian ministries diving head first into secularized culture.

First, I need to make a distinction. Whether an organization is non-profit (or, as it is sometimes called, not-for-profit) is a distinct statement from saying that it is tax exempt. Non-profit means that there are no equity owners to make a claim on the organization's net earnings. It does NOT mean that the organization is constrained to have revenues exactly equal to costs. Non-profit firms can and do make positive net earnings that are, in a real sense, "profits" from an economic modelling point of view. "Tax exempt status" is a benefit bestowed upon certain operations of certain non-profits based upon the social or community benefit of the organization's purpose. The tax exemptions can be from any level of government and cover a wide variety of taxes (corporate income taxes, property taxes, and so forth). Some non-profits have tax exempt status for some of their operations and not others. To give a specific example, I am the Treasurer of the Economic Science Association. We had to proceed in two steps: first, incorporating as a non-profit, and then applying for (and receiving) our tax exempt status.

The point of this article is that some United States Senators are questioning some $12 billion in federal tax breaks to non-profit hospitals. The rationales for these tax breaks are based upon the supposition that they provide more charity health care to the destitute than do for-profit hospitals. Apparently the senators are looking at numbers that suggest that such a distinction does not exist, or at least does not exist to a large degree, in practice.

What I would really like to know is not the comparison between all non-profit hospitals and for profit hospitals, but more specifically the comparison between nominally Christian non-profit hospitals and everyone else. In a span of 100+ years which has seen nominally Christian universities scramble to look like every other "Research I" university, I hope that I am wrong when I say that I fear that what are perceived as nominally Christian hospitals --- those numerous hospitals with names like "Baptist," or "Methodist," or "Presbyterian," or "St. Elsewhere" --- are virtually indistinguishable from any others in their scope and quantity of compassionate medical care. I don't want to single out any one hospital, but it's instructive to visit the web pages of some of these hospitals. I am sure they are doing wonderful work, and that as a well- insured middle-class American my medical needs would be spectacularly well taken care of. But, I look at these web sites, which are essentially indistinguishable from those of secular non-profit, government-owned, and for-profit hospitals, and I ask "Where does Jesus, whose Gospel is filled with compassionate healing ministries, fit into all of this?"

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