Should health-care be allowed to operate as Non-Profit ?

MplsGopher

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Top 100 Non-profits in Minnesota, according to STrib, by income.

A lot of these, including the largest by far, are health insurance companies or health-care providers (Mayo Clinic for example), and are giving out huge compensation to their execs.


Why on earth are we allowing them to be tax-exempt, when they're throwing millions of dollars at execs??? That does not seem right. That is not what a non-profit is to me.
 

MplsGopher

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And here is another article today showing how "non-profit" hospitals are trying to use state law and politics to force health insurers to allow patients to get certain procedures at hospitals instead of steering them into outpatient centers that have a lower cost.

"Non-profit" hospitals want to be able to charge more and get that money, for those procedures.
 

cncmin

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Non-profit regulations are clearly not appropriate. Non-profits pull a ton a shenanigans, and many of them are in health care and “religion”.
 

howeda7

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Non-profit regulations are clearly not appropriate. Non-profits pull a ton a shenanigans, and many of them are in health care and “religion”.
And "non-political education."
 

imthewalrus

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Top 100 Non-profits in Minnesota, according to STrib, by income.

A lot of these, including the largest by far, are health insurance companies or health-care providers (Mayo Clinic for example), and are giving out huge compensation to their execs.


Why on earth are we allowing them to be tax-exempt, when they're throwing millions of dollars at execs??? That does not seem right. That is not what a non-profit is to me.
How much is the tax revenue increased by the salaries paid to ALL the employees of a Mayo Clinic System in the state of Minnesota? Believe me, the state would suffer big time if not for the taxes paid by Mayo employees. Mayo also has a medical school that turns out many doctors. Mayo IS an educational system... like the University of Minnesota Medical School does and is ALSO a non-profit

Just what percentage of the medical care provided in the state of Minnesota is provided by Mayo Systems? A lot. Just like Abbot Northwestern, Methodist , Fairview /University of Minnesota hospital systems. It would be absolutely crazy to bitch about the large salaries these non profits have to pay to compete with for profit drug companies for talent. The highest paid employees all pay large tax bills to the state and federal governments. Why should state and federal tax collection agencies not have to pay taxes on ALL the $$$$ they collect from American citizens who are employees of both for profit and non- profit organizations? (I know that is kind of a joke...just like taxing our non-profit health organizations who also do research/teaching/and provide LOTS of free care for patients who show up in Emergency Rooms, are uninsured, have Medicare/Medicaid turned down submitted claims,etc. These systems don’t get paid for a lot they do for the government, the public and they are the LAST resort for many critically ill men, women, children, homeless, poverty stricken people that slip through all of the other safety net systems.

Why should real estate developers so often have so many special tax breaks they pay little to no taxes? (Has our king paid any taxes in the past 15 to 20 years?)

And why the heck should SO many for profit companies not pay ANY taxes? Just because of loop holes that have been gained for them by attorneys, high pressure lobby tactics and incompetent politicians?

I say thank God for the non -profit health care providers here in Minnesota. We have arguably some of the VERY best health care providers in the world right here in Minnesota. The innovations...the research...the patient care...and the incredible pool of medical talent assembled in the Twin Cities and across this state are a real blessing and we need to be thankful to our GREAT not for profit medical/ educational/hospital/ research world class medicine available here in mMinnesota. Shame on us if we fail to see the benefits of what our non-profit medical empire has done for the state of Minnesota and we people who live here...

I don’t want a trump...II don’t want a warren or a bernie. They are all three full of hate, extremism and are out of touch with reality. But I WANT my non-profit healthcare here in Minnesota!
 
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MplsGopher

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Was that ghost written for you by someone who works in their lobby firm?

Simple question: if these organizations really believed in their mission, to serve the greater good .... then why are execs taking such ridiculously large salaries??? Couldn't that money be better spent back into the mission??

Also, again, I thought the point of a non-profit is an entity that largely operates from donated income or even in-kind donations. A lot of these organizations have direct income-generating mechanisms. They don't need to ask for a single donation.

That's not a non-profit, to me, that's a business. I see no reason why they deserve special tax exemptions.


And sure, we should also address all the other tax loopholes you mention, perhaps more importantly and urgently. I was simply bringing this up because of the STrib article and how appauling I found it, how so many of these "non-profits" with income in the eight figures have execs ripping six figures salaries out of it !!

Do those people really make that big of a difference?? Are they generating seven figures of donations above some average level replacement?? Highly doubt it
 

KillerGopherFan

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College football head coaches work for a non-profit. Why are they paid such exorbitant salaries? Usually are a state’s highest paid employee. I wonder why? 🙄
 

MplsGopher

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College football head coaches work for a non-profit. Why are they paid such exorbitant salaries? Usually are a state’s highest paid employee.
You'll notice for example that the Univ of Minnesota isn't on the list.
 

MplsGopher

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Here's the correct answer, as I was curious about this myself: the U of MN is not required to file a Form 990 (which is how the STrib made the list), because the IRS has declared that the U is a "integral part" of the State of Minnesota.


That's it. So legally, in the sense of the 990 form, it is not a non-profit. It's something else.
 

KillerGopherFan

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Are you arguing that university employees aren’t state employees? B/c you’d be very wrong.

The point is that compensation has more to do with the need for competence, performance, and available financial resources than whether it’s a non-profit.
 

MplsGopher

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Are you arguing that university employees aren’t state employees?
No, was arguing that the highest paid state employee (often the head football coach at the public flagship university in a state, as you said) isn't necessarily an employee of a non-profit, in the sense of the companies listed in the OP.

The point is that compensation has more to do with the need for competence, performance, and available financial resources than whether it’s a non-profit.
That indeed is ostensible, claimed reasoning.
 

forever a gopher

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I have no problem with non-profits paying execs big $ if that helps them attract talent that can make them thrive. With that said, I work a lot with health care providers and they make ungodly amounts of money. If you are generating millions and millions of dollars through services rendered (not through donations, etc.), to me, that shouldn’t fall under the “non-profit” category.
 

MplsGopher

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If you are generating millions and millions of dollars through services rendered (not through donations, etc.), to me, that shouldn’t fall under the “non-profit” category.
Exactly.

There is no reason they shouldn't be paying state/federal income tax on their income.
 

KillerGopherFan

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I have no problem with non-profits paying execs big $ if that helps them attract talent that can make them thrive. With that said, I work a lot with health care providers and they make ungodly amounts of money. If you are generating millions and millions of dollars through services rendered (not through donations, etc.), to me, that shouldn’t fall under the “non-profit” category.
If you want to compare non-profit making healthcare organizations that compensate differently, compare non-profit hospitals to VA hospitals and tell me there’s no difference in quality and service?
 

jamiche

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And here is another article today showing how "non-profit" hospitals are trying to use state law and politics to force health insurers to allow patients to get certain procedures at hospitals instead of steering them into outpatient centers that have a lower cost.

"Non-profit" hospitals want to be able to charge more and get that money, for those procedures.
If a patient has a complication at a surgery center, they are screwed. The surgery center wants them out of there within a certain number of hours because that bed is needed. They are sent home too soon or to the ER by taxi, family member or ambulence. (I know from family members who have made that mistake.) The surgeons want the patients using their centers because it increases their revs. Anybody who has surgery done outside of a hospital is a moron.
 

imthewalrus

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Was that ghost written for you by someone who works in their lobby firm?

Simple question: if these organizations really believed in their mission, to serve the greater good .... then why are execs taking such ridiculously large salaries??? Couldn't that money be better spent back into the mission??

Also, again, I thought the point of a non-profit is an entity that largely operates from donated income or even in-kind donations. A lot of these organizations have direct income-generating mechanisms. They don't need to ask for a single donation.

That's not a non-profit, to me, that's a business. I see no reason why they deserve special tax exemptions.


And sure, we should also address all the other tax loopholes you mention, perhaps more importantly and urgently. I was simply bringing this up because of the STrib article and how appauling I found it, how so many of these "non-profits" with income in the eight figures have execs ripping six figures salaries out of it !!

Do those people really make that big of a difference?? Are they generating seven figures of donations above some average level replacement?? Highly doubt it
Check out the donations Mayo and Abbott and Methodist and Fairview/U of M, et al receive each year. They teach...they train...they provide free services and life saving care for free to some. They do research. They provide research from their data base of treatments, success rates dealing with various types of cancer and other diseases. They help with medical device instruments. They research drugs and potential cancer treatments. They have always worked to further medical care for the masses.

IF non-profits here in Minnesota don't stay in the competition for great talent, Johns Hopkins, Cleveland Clinic, some for profit HMO...United Health, et al will be raiding that talent from Mayo, Methodist, Abbott, F/U and will be paying them what their status will command.

Non-Profit health providers are working to make health care better. They always have. THEY set the standards for the physicians groups...Anesthesiologists groups who band together as for profit organizations and sell their services to hospitals.

When and IF hospitals/health care is totally dominated by for profit organizations rather than by the non-profits that are out there...it is going to be a SORRY, SORRY day for Joe Blow, Jane Johnson, Ida Infant, Archie Adolescent, Art Aging and the rest of us living in Minnesota and through out the United States.

Pick on non-profits at your own medical peril...All the great non-profit health systems we have in Minnesota really do help to keep all the for profit operations more honest.

Minnesota health care brings people to Minnesota from all over the country and all over the world. NEVER forget that...
 
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OldBob53

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We could save a lot of money-- trillions -- if we just let people die in peace. Resistance is futile, we will die non-the-less. Morphine is cheap and can alleviate suffering as we pass to the next world.
 

Cruze

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Summary of Main Points

- Over 80% of hospitals in the U.S. are non-profit.

- Very little of the care hospitals provide is uncompensated; about 2-4% on average. Deductions by Medicare, Medicaid and the [private] insurance companies account for almost all of the differences between billing charges and receipts.

- Private health insurance companies deliberately overpay hospitals to ensure that their revenues continue to grow each year.

- The proportion of a hospital bill a private insurance company pays is substantially higher, on average, than the proportion Medicare or Medicaid pays, and that difference has grown steadily since 2000.

- Hospital costs per enrollee have been nearly static for Medicare and Medicaid recipients since 2008, whereas they’ve grown by more than 60% for the privately insured.

- Even though hospitals in the U.S. are paid an average of less than 30% of what they bill, their profits margins have averaged around 8% in recent years.


http://truecostofhealthcare.org/hospital_financial_analysis/


Non-Profit Hospitals Are Making a Killing

The annual cost of health care for the average American family hovers around $20,000. Premiums increase yearly, and this is a primary driver of why real wages for average Americans don’t seem to improve.

Nearly half of the CEOs of America’s leading non-profit health systems made more than $2.5 million. Only eight of the 82 executives of non-profit companies earned less than $1 million.

These sorts of salaries amid the backdrop of struggling families would make even the most loyal believers in the free market pause—except this isn’t capitalism. This isn’t the market at work. It’s crony capitalism with the exploitation of market-related inefficiencies and rent-seeking behavior.

The problem is moral hazard in an administrative state.


Opening the Books

A recently published OpenTheBooks report shows just how the puppets are pulled by the strings of non-profit health systems.

The report investigated the leading 82 non-profit hospitals in the United States. The hospitals investigated in the report had combined net assets of $203.1 billion.

The average net asset growth over the last year was 23.6 percent. This was the average. Non-profit Ascension Health in St. Louis increased their net assets by 1,211 percent in one year.

For-profit hospitals averaged only a 1.5 percent growth rate over the same time period.

Additionally, roughly $2 billion flowed into non-profit health entities from federal agencies via grants. They also received charitable contributions of nearly $5.2 billion.

As a point of reference, the most highly compensated executive in the for-profit corporations studied in the report was at $6.3 million (CEO of Tenet Healthcare Corporation).

Meanwhile, the CEO of non-profit Banner Health, based out of Arizona, raked in $21.6 million last year.

https://fee.org/articles/non-profit-hospitals-are-making-a-killing/
 
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MplsGopher

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Thanks Cruze!

I'm really failing to see why these non-profit healthcare organizations (regardless if they're care providers or insurers) should be exempt from paying state or federal tax on their incomes.
 

MplsGopher

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Check out the donations Mayo and Abbott and Methodist and Fairview/U of M, et al receive each year. They teach...they train...they provide free services and life saving care for free to some. They do research. They provide research from their data base of treatments, success rates dealing with various types of cancer and other diseases. They help with medical device instruments. They research drugs and potential cancer treatments. They have always worked to further medical care for the masses.

IF non-profits here in Minnesota don't stay in the competition for great talent, Johns Hopkins, Cleveland Clinic, some for profit HMO...United Health, et al will be raiding that talent from Mayo, Methodist, Abbott, F/U and will be paying them what their status will command.

Non-Profit health providers are working to make health care better. They always have. THEY set the standards for the physicians groups...Anesthesiologists groups who band together as for profit organizations and sell their services to hospitals.

When and IF hospitals/health care is totally dominated by for profit organizations rather than by the non-profits that are out there...it is going to be a SORRY, SORRY day for Joe Blow, Jane Johnson, Ida Infant, Archie Adolescent, Art Aging and the rest of us living in Minnesota and through out the United States.

Pick on non-profits at your own medical peril...All the great non-profit health systems we have in Minnesota really do help to keep all the for profit operations more honest.

Minnesota health care brings people to Minnesota from all over the country and all over the world. NEVER forget that...
Thank you for the post, and the passion.

Certainly, I don't want to put Minnesota's organizations in a worse position than the equivalent organizations located in the rest of the states. I would guess that the rest of the major non-profit health organizations in other states are exactly the same: they generate huge incomes of their own mechanisms that have nothing to do with financial or in-kind donations, and they pay their executives grossly large salaries. Such scenarios are not deserving of tax exemptions, in my opinion.

All of them should be put in a position to pay state and federal taxes on their incomes. Or at least, their non-donation incomes.

I'm not suggesting a for-profit model is better or that they aren't doing good work as non-profits. I'm only suggesting they shouldn't get to cheat their way out of paying their fair share of taxes.
 

Nokomis

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Top 100 Non-profits in Minnesota, according to STrib, by income.

A lot of these, including the largest by far, are health insurance companies or health-care providers (Mayo Clinic for example), and are giving out huge compensation to their execs.


Why on earth are we allowing them to be tax-exempt, when they're throwing millions of dollars at execs??? That does not seem right. That is not what a non-profit is to me.
Was that ghost written for you by someone who works in their lobby firm?

Simple question: if these organizations really believed in their mission, to serve the greater good .... then why are execs taking such ridiculously large salaries??? Couldn't that money be better spent back into the mission??

Also, again, I thought the point of a non-profit is an entity that largely operates from donated income or even in-kind donations. A lot of these organizations have direct income-generating mechanisms. They don't need to ask for a single donation.

That's not a non-profit, to me, that's a business. I see no reason why they deserve special tax exemptions.


And sure, we should also address all the other tax loopholes you mention, perhaps more importantly and urgently. I was simply bringing this up because of the STrib article and how appauling I found it, how so many of these "non-profits" with income in the eight figures have execs ripping six figures salaries out of it !!

Do those people really make that big of a difference?? Are they generating seven figures of donations above some average level replacement?? Highly doubt it
You really don't know what a nonprofit is, then. Nonprofit does not equal charity. Nonprofits ARE businesses. There's just no ownership entity to payout. All profits are re-invested back into the organization.

Here's a book that might help your understanding of our health care crisis. It's written by a Mayo doctor. A quick & interesting read. He agrees that high admin costs are too blame. But you're barking up the wrong tree. The profit-motive, or "industrialized care" as he puts it, is the problem. Not their tax-exempt status.

 

MplsGopher

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You really don't know what a nonprofit is, then. Nonprofit does not equal charity. Nonprofits ARE businesses. There's just no ownership entity to payout. All profits are re-invested back into the organization.
You did not understand the OP, then. Your point here is a non-sequitor.

The entire point of this thread is that these non-profit organizations do not deserve tax exemption.

Nothing more
 

Nokomis

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You did not understand the OP, then. Your point here is a non-sequitor.

The entire point of this thread is that these non-profit organizations do not deserve tax exemption.

Nothing more
And I'm saying your understanding of nonprofits is grossly ill-informed. You raise some valid concerns but are coming at it from the wrong angle.
 

MplsGopher

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And I'm saying your understanding of nonprofits is grossly ill-informed.
Do they have tax exemption?

That is the only relevant part of it, to this discussion. You're trying to inject a red herring into it.
 

imthewalrus

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Well, say what you will, think what you want, support all the for profit health care providers you can find when you become ill, are laid low by disease, viral infection, the ravages of time, old age or even accident.

hope you don’t need a hospital, because virtually all of the best comprehensive health care providers and not for profit, do not pay dividends to their shareholders and investors, and certainly not run their hospitals from quarter to quarter based upon last quarters results. Just like superstores and drug stores and super markets may offer flue shots or some partial service stop by for pink eye drops and other very simple quick fixes that are easy hanging fruit and are lower cost/high profit/low risk health care services, what will those little kiosks do for you when your kid fractures a leg, your wife has severe complications giving birth, you are rushed to the for profit surgery center with severe chest pains, symptoms of stroke or so many other emergency situations?

For profit places have to manage their supply chain, their inventory, their staff levels all based on for profit drivers, motives, and uses of$$$$$.
Non-profit hospitals must be prepared for ANYTHING...EVERYTHING that may come their way ALL the time.
You really should use for-profit facilities ALL the time for ALL of your medical needs if you are so troubled by the fact that a health care system NEEDS to hire, employ and PAY highly skilled and valued super star ceo / head coaches/difference makers running their multi- billion revenue producing organizations and keep their health care facility ranked or in the running to be ranked #1 in the nation year in and year out.

By the way: how well has the strib been run over the decades? But, that is neither here nor there...

As for me,I am thankful that the Brothers Mayo poured their profits back into their mission, had the wisdom, courage and common sense to VALUE talent and pay that talent to do GREAT things and to value education, the sharing of knowledge, techniques and training as the GOLD standard...the ONLY standard to provide health care for the state...the nation...the world. Much of medicine, can NOT be patented And profited from the way pharmaceutical companies do...0r Cargill does with their private, for profit distribution of grain, ag product , food chain services. Target, Walmart, 3M, Delta, Hormel,General Mills, Econ, Boeing, the defense contractors, Amazon,Apple, Google,
Fox News... and on...and on and on.

Non- profit organizations are there for the PUBLIC needs. They are the most valuable safeguards for their communities, their counties, their regions, their states and their nations. They are open for virtually every nation...no border...no “beautiful” steel towering walls to keep people out OR in.

I am so thankful for the incredibly well paid and gifted and valuable talent that keeps Mayo and all the non-profit hospitals, educational centers open, running and available to all of us whenever any of us NEED them!
 

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Don't forget - if you can't pay or are foreign, black or a Democrat, Section2's hospital will be off-limits. But there's one 150 miles that way, so if you hurry, your hemorrhaging will probably hang tough and you'll be ok.
 

Nokomis

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You did not understand the OP, then. Your point here is a non-sequitor.

The entire point of this thread is that these non-profit organizations do not deserve tax exemption.

Nothing more
Do they have tax exemption?

That is the only relevant part of it, to this discussion. You're trying to inject a red herring into it.
Did you know Mayo Clinic still has an employee pension? Not just 401(k) (they also have that) but an actual pension. Pensions are all but extinct in most other American companies. Do you think that also makes their tax-exempt status undeserving? Or are you still chasing the exec compensation red herring.
 

John Galt

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Top 100 Non-profits in Minnesota, according to STrib, by income.

A lot of these, including the largest by far, are health insurance companies or health-care providers (Mayo Clinic for example), and are giving out huge compensation to their execs.


Why on earth are we allowing them to be tax-exempt, when they're throwing millions of dollars at execs??? That does not seem right. That is not what a non-profit is to me.
Non-profit is a tax status, not a business strategy.
 
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